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General NPI Number Information
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NPI Number | 1821303900
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Entity Type | Organization
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Legal Business Name | SAN LUIS OBISPO HEALTH FACILITY
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Dates
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Enumeration Date | 08/12/2010
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Last Update Date | 08/12/2010
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Provider Practice Location Address
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Address Line | 2178 JOHNSON AVE
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-4535
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Country | US
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Telephone | 805-781-5959
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Fax |
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Provider Business Mailing Address
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Address Line | 2178 JOHNSON AVE
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City | SAN LUIS OBISPO
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State | CA
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Zip | 93401-4535
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Country | US
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Telephone | 805-781-5959
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Fax |
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Authorized Official
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Title or Position | STAFF NURSE
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Name | MRS. KATHERINE ANN MCMANUS
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Credential | R.N.
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Telephone | 805-781-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310500000X
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Taxonomy Name | Mental Illness Intermediate Care Facility
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License Number |
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License Number State |
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