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Organization
BRADFORD HOME INC.
Active
Organization
BRADFORD HOME INC.
Active
Other names
BRADFORD HOME, ICF DDN
Organization subpart
No
Provider details
NPI number
Authorized official
ESTELITA EVANGELISTA RN (ADMINISTRATOR)
(415) 987-3401
Entity
Organization
Contact information
Practice address
59 BRADFORD DR, SOUTH SAN FRANCISCO, CA 94080-1129
(415) 987-3401
Mailing address
59 BRADFORD DR, SOUTH SAN FRANCISCO, CA 94080-1129
(415) 987-3401
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
55-G537
PROVIDER NUMBER
CA
Enumeration date
05/16/2007
Last updated
08/22/2020
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