Organization
SPECIAL REQUEST LLC
Active
Other names
Lake Chabot Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMUEL ALIN TET (LLC MEMBER)
(510) 292-8610
Entity
Organization
Contact information
Practice address
18821 CARLTON AVE, CASTRO VALLEY, CA 94546-2907
(415) 797-9266
Mailing address
18821 CARLTON AVE, CASTRO VALLEY, CA 94546-2907
(415) 797-9266
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
Primary
—
—
Other
Enumeration date
11/20/2019
Last updated
11/20/2019
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