Healthcare Provider Details

I. General information

NPI: 1760312565
Provider Name (Legal Business Name): CORE UNITY LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2532 VISTA VERDE DR
SAN JOSE CA
95148-2057
US

IV. Provider business mailing address

3477 MCKEE RD # 185
SAN JOSE CA
95127-2233
US

V. Phone/Fax

Practice location:
  • Phone: 408-599-9054
  • Fax:
Mailing address:
  • Phone: 408-599-9054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: ANDREA GOMEZ
Title or Position: MANAGING MEMBER
Credential:
Phone: 408-599-9054