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General NPI Number Information
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NPI Number | 1912909177
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Entity Type | Organization
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Legal Business Name | NURSING & REHAB AT HOME
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Dates
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Enumeration Date | 06/01/2005
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1710 S AMPHLETT BLVD STE 110
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City | SAN MATEO
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State | CA
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Zip | 94402-2704
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Country | US
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Telephone | 650-286-4272
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Fax | 650-249-4238
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Provider Business Mailing Address
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Address Line | 1710 S AMPHLETT BLVD STE 110
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City | SAN MATEO
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State | CA
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Zip | 94402-2704
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Country | US
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Telephone | 650-286-4272
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Fax | 650-249-4238
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Authorized Official
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Title or Position | OWNER/CEO/ADMINISTRATOR
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Name | LORNA S BEUKEMA
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Credential | PT
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Telephone | 650-551-7522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 220000467
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License Number State | CA
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