Organization
LESTERS HOME INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARISSA LEGARDA (PRESIDENT CEO)
(650) 273-8181
Entity
Organization
Contact information
Practice address
3271 SUSAN DR, SAN BRUNO, CA 94066-1639
(650) 273-8181
(650) 359-7865
Mailing address
3271 SUSAN DR, SAN BRUNO, CA 94066-1639
(650) 273-8181
(650) 359-7865
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
220000483
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LTC61017F
—
CA
Enumeration date
04/16/2007
Last updated
03/02/2015
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