# BRODERICK SKILLED NURSING FACILITY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1043599251
- **Authorized official:** LETICIA LUCERO DE SILVA (L.V.N.)
- **Authorized official phone:** (650) 921-5633

## Contact information

- **Practice address:** 1421 BRODERICK ST, SAN FRANCISCO, CA 94115-3304
- **Practice address phone:** (415) 292-1760
- **Practice address fax:** (415) 292-1636
- **Mailing address:** 1421 BRODERICK ST, SAN FRANCISCO, CA 94115-3304
- **Mailing address phone:** (415) 292-1760
- **Mailing address fax:** (415) 292-1636

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | 258102 | CA | Yes |

## Other

- **Enumeration date:** 08/05/2011
- **Last updated:** 08/08/2011