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General NPI Number Information
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NPI Number | 1952028441
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Entity Type | Organization
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Legal Business Name | E & J CARE PROVIDER, INC.
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Dates
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Enumeration Date | 10/25/2022
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Last Update Date | 10/25/2022
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Provider Practice Location Address
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Address Line | 3262 SANTA ISABELLA CT
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City | UNION CITY
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State | CA
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Zip | 94587-2736
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Country | US
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Telephone | 408-674-8394
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Fax |
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Provider Business Mailing Address
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Address Line | 5232 MAKATI CIR
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City | SAN JOSE
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State | CA
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Zip | 95123-6244
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Country | US
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Telephone | 408-674-8394
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Fax |
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Authorized Official
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Title or Position | CEO & PRESIDENT
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Name | JULIETA TORRES ABAD
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Credential |
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Telephone | 408-674-8394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number |
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License Number State |
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