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General NPI Number Information
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NPI Number | 1932596947
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Entity Type | Organization
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Legal Business Name | TOGETHER WE GROW
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Dates
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Enumeration Date | 04/17/2015
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Last Update Date | 04/17/2015
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Provider Practice Location Address
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Address Line | 2120 THIBODO RD
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City | VISTA
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State | CA
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Zip | 92081-7901
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Country | US
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Telephone | 760-466-3560
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Fax |
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Provider Business Mailing Address
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Address Line | 5055 VIEWRIDGE AVE
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City | SAN DIEGO
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State | CA
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Zip | 92123-4313
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Country | US
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Telephone | 858-751-0209
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Fax | 760-466-3566
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TERRY JANE RACCIATO
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Credential | RN, PHN
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Telephone | 760-466-3560
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385HR2060X
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Taxonomy Name | Child Intellectual and/or Developmental Disabilities Respite Care
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License Number | 080000750
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 385HR2065X
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Taxonomy Name | Child Physical Disabilities Respite Care
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License Number | 080000750
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 080000750
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License Number State | CA
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