Organization
STATCARE RECRUITING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN GRIVAS LVN (PRINCIPLE/ADMINISTRATOR)
(855) 424-4473
Entity
Organization
Contact information
Practice address
139 LUCCA DR, SOUTH SAN FRANCISCO, CA 94080-7100
(855) 424-4473
(855) 793-7333
Mailing address
139 LUCCA DR, SOUTH SAN FRANCISCO, CA 94080-7100
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
108325
CA
Other
Enumeration date
08/08/2015
Last updated
08/08/2015
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