Organization
ELENA'S ICF DDH #3 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELENA DUMITRESCU (CFO)
(510) 785-8137
Entity
Organization
Contact information
Practice address
1162 MERRITT LN, HAYWARD, CA 94545-2529
(510) 785-8137
(510) 780-9836
Mailing address
1162 MERRITT LN, HAYWARD, CA 94545-2529
(510) 785-8137
(510) 780-9836
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
020000568
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
55G196
—
CA
Enumeration date
12/28/2006
Last updated
07/16/2008
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