Organization
RDD ICF, INC.
Active
Other names
CRANE HOUSE
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DEYRA TAMBOT SUNGA RN (ADMINISTRATOR)
(650) 892-4572
Entity
Organization
Contact information
Practice address
741 ADA ST, SAN MATEO, CA 94401-3101
(650) 216-9455
Mailing address
2893 EL CAMINO REAL STE C, REDWOOD CITY, CA 94061-4039
(650) 216-9960
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
220000350
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55G026
—
CA
Enumeration date
05/21/2009
Last updated
05/21/2009
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