Organization
PORTOLA GARDENS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK J. CIMINO (LICENSEE)
(916) 704-6275
Entity
Organization
Contact information
Practice address
350 UNIVERSITY STREET, SAN FRANCISCO, CA 94143
(415) 337-1587
(415) 337-1573
Mailing address
350 UNIVERSITY STREET, SAN FRANCISCO, CA 94143
(415) 337-1587
(415) 337-1573
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
385600402
CA
Other
Enumeration date
05/31/2018
Last updated
05/31/2018
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