MEDICARE: TOGETHER WE GROW

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	3140N1450X	Pediatric Skilled Nursing Facility		CA

General Provider Information

NPI Number	:	1740214709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOGETHER WE GROW

Provider Business Mailing Address
First Line	:	5055 VIEWRIDGE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4313
Country	:	US
Telephone Number	:	858-751-0209
Fax Number	:	858-751-0204

Provider Business Practice Location Address
First Line	:	5055 VIEWRIDGE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92123-4313
Country	:	US
Telephone Number	:	858-751-0209
Fax Number	:	858-751-0204

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TERRY JANE RACCIATO
Credential	:	RN
Telephone Number	:	858-751-0209

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	08/22/2020

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Directions to “TOGETHER WE GROW ” Practice Location

Language	Start Address	Practice Location

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