Organization
GRACE COMMUNITY CENTER DAY REHABILITATION PROGRAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA BLEVINS PHD (DIRECTOR)
(408) 794-7592
Entity
Organization
Contact information
Practice address
146 S 10TH ST, SAN JOSE, CA 95112-3641
(408) 794-7580
Mailing address
146 S 10TH ST, SAN JOSE, CA 95112-3641
(408) 794-7580
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
14707
CA
Other
Enumeration date
06/19/2012
Last updated
06/19/2012
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