Healthcare Provider Details

I. General information

NPI: 1700873957
Provider Name (Legal Business Name): ST. ANNE'S HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 LAKE ST
SAN FRANCISCO CA
94118-1357
US

IV. Provider business mailing address

300 LAKE ST
SAN FRANCISCO CA
94118-1357
US

V. Phone/Fax

Practice location:
  • Phone: 415-751-6510
  • Fax: 415-751-1423
Mailing address:
  • Phone: 415-751-6510
  • Fax: 415-751-1423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: SISTER ANTHONY SELEWICZ
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 415-751-6510