Healthcare Provider Details

I. General information

NPI: 1093872715
Provider Name (Legal Business Name): CENTRAL GARDENS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1355 ELLIS ST
SAN FRANCISCO CA
94115-4215
US

IV. Provider business mailing address

1355 ELLIS ST
SAN FRANCISCO CA
94115-4215
US

V. Phone/Fax

Practice location:
  • Phone: 415-567-2967
  • Fax: 415-567-5933
Mailing address:
  • Phone: 415-567-2967
  • Fax: 415-567-5933

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: JENNIFER LEMMON
Title or Position: OFFICE MANAGER
Credential:
Phone: 415-567-2967