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General NPI Number Information
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NPI Number | 1952807695
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Entity Type | Organization
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Legal Business Name | LIFEMOVES - MONTGOMERY STREET INN
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Dates
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Enumeration Date | 04/02/2018
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Last Update Date | 06/01/2018
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Provider Practice Location Address
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Address Line | 358 N MONTGOMERY ST
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City | SAN JOSE
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State | CA
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Zip | 95110
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Country | US
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Telephone | 408-271-5160
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Fax |
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Provider Business Mailing Address
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Address Line | 358 N MONTGOMERY ST
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City | SAN JOSE
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State | CA
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Zip | 95110-2325
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Country | US
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Telephone | 408-271-5160
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | CRAIG GARBER
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Credential |
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Telephone | 650-685-5880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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