Organization
REDENCION A LELCHUK
Active
Other names
Bahama Home ICF DDH
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. REDENCION ALINAS LELCHUK (OWNER ADMINISTRATOR)
(510) 887-6677
Entity
Organization
Contact information
Practice address
27495 BAHAMA AVENUE, HAYWARD, CA 94545
(510) 670-0207
(510) 732-9103
Mailing address
2691 BEACHWOOD STREET, HAYWARD, CA 94545
(510) 670-0207
(510) 732-9103
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05 G933
IDENTIFICATION NUMBER
—
Enumeration date
02/07/2007
Last updated
08/22/2020
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