MEDICARE: MOURI MANAGEMENT GROUP INCORPORATED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility	LTC80244F	CA
2	315P00000X	Intellectual Disabilities Intermediate Care Facility

General Provider Information

NPI Number	:	1245380146
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MOURI MANAGEMENT GROUP INCORPORATED

Provider Business Mailing Address
First Line	:	3220 FLINTDALE DRIVE
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95148-1231
Country	:	US
Telephone Number	:	408-531-9126
Fax Number	:	408-531-9020

Provider Business Practice Location Address
First Line	:	394 GRIDLEY ST
Second Line	:
City	:	SAN JOSE
State	:	CA
Zip	:	95127-1522
Country	:	US
Telephone Number	:	408-729-5717
Fax Number	:	408-729-5717

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	NOEL DE JESUS
Credential	:
Telephone Number	:	408-531-9126

Provider Enumeration Date	:	01/11/2007
Last Update Date	:	04/10/2020

Similar Medicare Providers

1881914000 — GRUPO MEDICO POLICLINICA SAN PEDRO MEDICARE ADVANTAGE
Practice Location Address:

211 CALLE MORSE
ARROYO, PR
00714-2350

Practice Phone: 787-839-3980
Practice Fax: 787-271-2515

1629069794 — DR. TZUOO-MING YEH M.D.
Practice Location Address:

2407 FOREST AVE
SAN JOSE, CA
95128-1522

Practice Phone: 408-296-3288
Practice Fax: 408-296-3688

1861056962 — BLANCA GLORIA AVILA
Practice Location Address:

1522 HILLSDALE AVE
SAN JOSE, CA
95118-1037

Practice Phone: 408-655-1391
Practice Fax:

1811599509 — VANESSA VALDEZ
Practice Location Address:

3165 GARDENDALE DR
SAN JOSE, CA
95118-1522

Practice Phone: 408-963-8169
Practice Fax:

1295439552 — CHRISTINE BACON SLP
Practice Location Address:

540 COAKLEY DR
SAN JOSE, CA
95117-1522

Practice Phone: 408-921-6863
Practice Fax:

1437038007 — JINXIU MA GRAFF
Practice Location Address:

2407 FOREST AVE
SAN JOSE, CA
95128-1522

Practice Phone: 925-788-6812
Practice Fax:

Directions to “MOURI MANAGEMENT GROUP INCORPORATED ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.