# LINCOLN GLEN SKILLED NURSING FACILITY

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

## Provider details

- **NPI number:** 1093704249
- **Authorized official:** JAMES BRADLEY MORTENSEN LNHA (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (408) 757-8580

## Contact information

- **Practice address:** 2671 PLUMMER AVE, SAN JOSE, CA 95125-4867
- **Practice address phone:** (408) 265-3222
- **Practice address fax:** (408) 448-1533
- **Mailing address:** 2671 PLUMMER AVE, SAN JOSE, CA 95125-4867
- **Mailing address phone:** (408) 265-3222
- **Mailing address fax:** (408) 448-1533

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 31400000X | CA | Yes |

## Other

- **Enumeration date:** 10/20/2005
- **Last updated:** 12/13/2024