Provider Demographics
NPI:1407390875
Name:SAINT ANTHONY'S CARE HOME FOR THE ELDERLY
Entity type:Organization
Organization Name:SAINT ANTHONY'S CARE HOME FOR THE ELDERLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:JAVIER
Authorized Official - Last Name:CASTILLEJO
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:408-478-1288
Mailing Address - Street 1:3258 EVCO CT
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-1502
Mailing Address - Country:US
Mailing Address - Phone:408-708-4164
Mailing Address - Fax:
Practice Address - Street 1:3258 EVCO CT
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-1502
Practice Address - Country:US
Practice Address - Phone:408-708-4164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-05
Last Update Date:2016-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435294209310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility