Provider Demographics
NPI:1306479696
Name:HAFCO ELDER CARE
Entity type:Organization
Organization Name:HAFCO ELDER CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-218-6776
Mailing Address - Street 1:259 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94112-2926
Mailing Address - Country:US
Mailing Address - Phone:415-218-6776
Mailing Address - Fax:
Practice Address - Street 1:1420 HAMPSHIRE ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4818
Practice Address - Country:US
Practice Address - Phone:415-285-7660
Practice Address - Fax:415-285-7057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-15
Last Update Date:2020-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility