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Organization
TERRA BELLA COMMUNITIES
Active
Organization
TERRA BELLA COMMUNITIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA MCCORMACK (LICENSEE)
(408) 713-2770
Entity
Organization
Contact information
Practice address
7630 WREN AVENUE, GILROY, CA 95020
(408) 848-3226
(408) 848-3226
Mailing address
7990 WESTWOOD DRIVE, GILROY, CA 95020
(408) 713-2770
(408) 713-2778
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
70000374
CA
315P00000X
Intellectual Disabilities Intermediate Care Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05G290
—
CA
05
—
55G290
—
CA
Enumeration date
05/09/2008
Last updated
04/09/2014
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