Provider Demographics
NPI:1003106832
Name:TUPAZ DAY CARE SERVICES
Entity Type:Organization
Organization Name:TUPAZ DAY CARE SERVICES
Other - Org Name:GREAT ENDEAVORS - BASCOM
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BEEBE
Authorized Official - Middle Name:
Authorized Official - Last Name:TUPAZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-377-1622
Mailing Address - Street 1:1305 N BASCOM AVE
Mailing Address - Street 2:SUITE J
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-1248
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1305 N BASCOM AVE
Practice Address - Street 2:SUITE J
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-1248
Practice Address - Country:US
Practice Address - Phone:408-377-1622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services