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General NPI Number Information
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NPI Number | 1144569039
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Entity Type | Organization
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Legal Business Name | HEARTS & MINDS ACTIVITY CENTER
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Dates
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Enumeration Date | 02/12/2013
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Last Update Date | 08/22/2023
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Provider Practice Location Address
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Address Line | 2380 ENBERG LANE
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City | SAN JOSE
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State | CA
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Zip | 95128-2146
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Country | US
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Telephone | 408-279-7515
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Fax | 408-279-7519
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Provider Business Mailing Address
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Address Line | 2380 ENBERG LANE
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City | SAN JOSE
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State | CA
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Zip | 95128-2146
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Country | US
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Telephone | 408-279-7515
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Fax | 408-279-7519
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Authorized Official
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Title or Position | CEO
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Name | MS. MARIA ANGELICA NICOLACOUDIS
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Credential | MA
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Telephone | 408-279-7515
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | 435202011
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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