Healthcare Provider Details

I. General information

NPI: 1760656128
Provider Name (Legal Business Name): JTM HOMES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 ARLINGTON DR
SOUTH SAN FRANCISCO CA
94080-1126
US

IV. Provider business mailing address

81 ARLINGTON DR
SOUTH SAN FRANCISCO CA
94080-1126
US

V. Phone/Fax

Practice location:
  • Phone: 650-991-2601
  • Fax: 650-991-2098
Mailing address:
  • Phone: 650-991-2601
  • Fax: 650-991-2098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateCA

VIII. Authorized Official

Name: MRS. JENNIFER GUERRERO MOREIRA
Title or Position: PRESIDENT
Credential:
Phone: 650-996-9198