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General NPI Number Information
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NPI Number | 1881838449
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Entity Type | Organization
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Legal Business Name | GOOD SHEPHERD HOLDINGS CORP
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 04/27/2009
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Provider Practice Location Address
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Address Line | 16 E 3RD AVE SUITE 4
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City | SAN MATEO
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State | CA
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Zip | 94401-4033
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Country | US
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Telephone | 650-685-5448
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Fax | 650-685-5549
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Provider Business Mailing Address
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Address Line | 16 E 3RD AVE SUITE 4
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City | SAN MATEO
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State | CA
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Zip | 94401-4033
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Country | US
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Telephone | 650-685-5448
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Fax | 650-685-5549
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Authorized Official
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Title or Position | OWNER / PRESIDENT
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Name | MR. EDWARD SAYSON
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Credential |
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Telephone | 650-685-5448
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State | CA
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Taxonomy #2
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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 | CA
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