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General NPI Number Information
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NPI Number | 1487250841
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Entity Type | Organization
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Legal Business Name | PIGEON HOLLOW INC.
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Dates
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Enumeration Date | 12/09/2020
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Last Update Date | 12/09/2020
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Provider Practice Location Address
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Address Line | 777 GRAND AVE STE 101
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City | SAN RAFAEL
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State | CA
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Zip | 94901-3509
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Country | US
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Telephone | 415-300-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 33 PIGEON HOLLOW RD
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City | SAN RAFAEL
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State | CA
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Zip | 94901-2345
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Country | US
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Telephone | 415-999-4400
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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. SEAN ZIEGLER
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Credential |
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Telephone | 415-300-2273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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