Healthcare Provider Details

I. General information

NPI: 1275525115
Provider Name (Legal Business Name): HEBREW HOME FOR AGED DISABLED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 02/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 SILVER AVE
SAN FRANCISCO CA
94112-1510
US

IV. Provider business mailing address

302 SILVER AVE
SAN FRANCISCO CA
94112-1510
US

V. Phone/Fax

Practice location:
  • Phone: 415-334-2500
  • Fax: 415-333-4345
Mailing address:
  • Phone: 415-334-2500
  • Fax: 415-333-4345

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number220000224
License Number StateCA

VIII. Authorized Official

Name: ROSABELLA BRAY
Title or Position: DIRECTOR OF PATIENT FINANCIAL SVCS.
Credential:
Phone: 415-562-2689