Organization
EMERALD KEY VILLA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELINA QUEDADO DOOLABH RN (CORPORATE OFFICER)
(408) 390-8533
Entity
Organization
Contact information
Practice address
15860 SIESTA VISTA DRIVE, SAN JOSE, CA 95127
(408) 390-8533
Mailing address
PO BOX 32804, SAN JOSE, CA 95152
(408) 390-8533
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
01/12/2011
Last updated
01/12/2011
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