Organization
GRACE COMMUNITY CENTER
Active
Parent organization
CITY OF SAN JOSE
Organization subpart
Yes
Provider details
NPI number
Legal business name
CITY OF SAN JOSE
Authorized official
DR. LISA ANN BLEVINS PH.D. (THERAPEUTIC SERVICE MANAGER)
(408) 293-0422
Entity
Organization
Contact information
Practice address
484 E SAN FERNANDO ST, SAN JOSE, CA 95112-3513
(408) 293-0422
Mailing address
484 E SAN FERNANDO ST, SAN JOSE, CA 95112-3513
(408) 293-0422
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42502
PARCCA
CA
Enumeration date
07/21/2008
Last updated
07/21/2008
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