Organization
LIFEMOVES - MONTGOMERY STREET INN
Active
Parent organization
LIFEMOVES - AUTUMN SATELLITE CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFEMOVES - AUTUMN SATELLITE CLINIC
Authorized official
CRAIG GARBER (CHIEF FINANCIAL OFFICER)
(650) 685-5880
Entity
Organization
Contact information
Practice address
358 N MONTGOMERY ST, SAN JOSE, CA 95110
(408) 271-5160
Mailing address
358 N MONTGOMERY ST, SAN JOSE, CA 95110-2325
(408) 271-5160
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
04/02/2018
Last updated
06/01/2018
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