Provider Demographics
NPI: | 1386678340 |
---|---|
Name: | TOGETHER WE GROW |
Entity type: | Organization |
Organization Name: | TOGETHER WE GROW |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PRESIDENT |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TERRY |
Authorized Official - Middle Name: | JANE |
Authorized Official - Last Name: | RACCIATO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | RN |
Authorized Official - Phone: | 858-751-0209 |
Mailing Address - Street 1: | 5055 VIEWRIDGE AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | SAN DIEGO |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 92123-4313 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 858-751-0209 |
Mailing Address - Fax: | 858-751-0204 |
Practice Address - Street 1: | 3815 MISSION AVE STE 107 |
Practice Address - Street 2: | |
Practice Address - City: | OCEANSIDE |
Practice Address - State: | CA |
Practice Address - Zip Code: | 92054-1815 |
Practice Address - Country: | US |
Practice Address - Phone: | 760-757-6031 |
Practice Address - Fax: | 760-757-4813 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-07-10 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 3140N1450X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 3140N1450X | Nursing & Custodial Care Facilities | Skilled Nursing Facility | Nursing Care, Pediatric |