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General NPI Number Information
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NPI Number | 1154273696
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Entity Type | Organization
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Legal Business Name | CHILDREN COUNTRY & LIVES (CCL)
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Dates
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Enumeration Date | 02/09/2026
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 2579 BRIDLE PATH DR BLDG B
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City | GILROY
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State | CA
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Zip | 95020-9185
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Country | US
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Telephone | 408-621-5262
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Fax |
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Provider Business Mailing Address
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Address Line | 2579 BRIDLE PATH DR BLDG B
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City | GILROY
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State | CA
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Zip | 95020-9185
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Country | US
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Telephone | 408-621-5262
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | ALMA D MORENO
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Credential |
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Telephone | 408-621-5262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174200000X
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Taxonomy Name | Meals Provider
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 177F00000X
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Taxonomy Name | Lodging Provider
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332U00000X
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Taxonomy Name | Home Delivered Meals
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number |
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License Number State |
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