Organization
FERN LODGE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE STRONG (ADMINISTRATOR)
(510) 886-2448
Entity
Organization
Contact information
Practice address
18457 MADISON AVE, CASTRO VALLEY, CA 94546-1637
(510) 886-2448
(510) 886-5992
Mailing address
18457 MADISON AVE, CASTRO VALLEY, CA 94546-1637
(510) 886-2448
(510) 886-5992
Taxonomy
Speciality
Code
Description
License number
State
282J00000X
Religious Nonmedical Health Care Institution
Primary
—
—
Other
Enumeration date
10/11/2007
Last updated
01/16/2008
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