Organization
GIMAG TRANSITIONAL CARE
Active
Other names
Manley House
Organization subpart
No
Provider details
NPI number
Authorized official
OLUBUSAYO P EKUNBOYEJO (COO)
(510) 435-4946
Entity
Organization
Contact information
Practice address
1280 MANLEY DR, TRACY, CA 95377-8808
(510) 435-4946
Mailing address
704 W REDLANDS AVE, MOUNTAIN HOUSE, CA 95391-1203
(510) 435-4946
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000000
PRIVATE INSURANCE, WORKERS COMPENSATION AND PRIVATE
CA
Enumeration date
03/21/2022
Last updated
03/21/2022
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