Organization
TOGETHER WE GROW
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRY JANE RACCIATO RN, PHN (PRESIDENT)
(760) 466-3560
Entity
Organization
Contact information
Practice address
2120 THIBODO RD, VISTA, CA 92081-7901
(760) 466-3560
Mailing address
5055 VIEWRIDGE AVE, SAN DIEGO, CA 92123-4313
(858) 751-0209
(760) 466-3566
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
080000750
CA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
080000750
CA
385HR2065X
Child Physical Disabilities Respite Care
080000750
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386678340
—
CA
05
—
1740214709
—
CA
Enumeration date
04/17/2015
Last updated
04/17/2015
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