Lesters Home INC.
Residential Treatment Facility, Intellectual and/or Developmental Disabilities in San Bruno, CA. Organization (NPI-2).
NPI number1154714616
StatusActive
Last updated in NPPESMar 9, 2015
Details
- NPI
- 1154714616
- Entity type
- Organization (NPI-2)
- Legal business name
- Lesters Home INC.
- Organization subpart
- No
- Enumeration date
- Mar 9, 2015
- Last updated
- Mar 9, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 320600000X | Residential Treatment Facility, Intellectual and/or Developmental Disabilities | 220000483 | CA | Yes |
Practice location
3271 Susan DrSan Bruno, CA 94066-1639
Phone 650-359-7865 · Fax 650-359-7865
Mailing address
3271 Susan DrSan Bruno, CA 94066-1639
Phone 650-359-7865 · Fax 650-359-7865
Authorized official
Louie Barangan
Qidp
6503882507
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