Healthcare Provider Details

I. General information

NPI: 1922947910
Provider Name (Legal Business Name): OUR COMMON GROUND, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 MELECH RD
SAN JOSE CA
95138
US

IV. Provider business mailing address

631 WOODSIDE ROAD
REDWOOD CITY CA
94061
US

V. Phone/Fax

Practice location:
  • Phone: 650-703-5340
  • Fax: 650-364-7987
Mailing address:
  • Phone: 650-703-5340
  • Fax: 650-364-7987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ORVILLE ROACHE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 650-703-5340