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General NPI Number Information
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NPI Number | 1093156952
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Entity Type | Organization
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Legal Business Name | GARDENIA SENIOR CARE CENTER INC
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Dates
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Enumeration Date | 07/08/2013
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Last Update Date | 07/08/2013
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Provider Practice Location Address
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Address Line | 19317 SANTA MARIA AVE
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-3402
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Country | US
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Telephone | 510-604-0348
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Fax | 510-763-7367
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Provider Business Mailing Address
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Address Line | 19317 SANTA MARIA AVE
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City | CASTRO VALLEY
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State | CA
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Zip | 94546-3402
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Country | US
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Telephone | 510-604-0348
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Fax | 510-763-7367
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Authorized Official
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Title or Position | PRESIDENT
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Name | MISS NOORJAHAN SYED
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Credential |
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Telephone | 510-604-0348
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 015601426
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License Number State | CA
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