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General NPI Number Information
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NPI Number | 1104066976
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Entity Type | Organization
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Legal Business Name | TUPAZ DAY CARE SERVICES
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 03/05/2009
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Provider Practice Location Address
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Address Line | 3015 UNION AVE
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City | SAN JOSE
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State | CA
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Zip | 95124-2006
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Country | US
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Telephone | 408-377-1622
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Fax | 408-377-1143
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Provider Business Mailing Address
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Address Line | 2831 CORTINA WAY
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City | UNION CITY
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State | CA
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Zip | 94587-1553
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Country | US
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Telephone | 408-377-1622
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. BEEBE TUPAZ
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Credential |
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Telephone | 408-377-1622
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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