Organization · NPI-2
1125 Sir Francis Drake Boulevard Operating Company, LLC
Long Term Care Hospital · San Francisco, CA
NPI number1386009108
StatusActive
Last updated in NPPESOct 6, 2023
Details
- NPI
- 1386009108
- Entity type
- Organization (NPI-2)
- Legal business name
- 1125 Sir Francis Drake Boulevard Operating Company, LLC
- Organization subpart
- No
- Enumeration date
- Dec 21, 2015
- Certification date
- Oct 6, 2023
- Last updated
- Oct 6, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 282E00000X | Long Term Care Hospital | – | CA | Yes |
Other names
- Kentfield Hospital San Francisco (Doing Business As)
Practice location
450 Stanyan St6th Floor
San Francisco, CA 94117-1019
Phone 415-456-9680 · Fax 415-688-3202
Mailing address
700 17th St Ste 205Modesto, CA 95354-1249
Phone 209-287-6308 · Fax 209-248-7825
Authorized official
Tammy Jean Thompson
Cfo/Vp
2092876308
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