Provider Demographics
NPI:1205378981
Name:ALMOND ROAD. SENIOR ESTATES
Entity Type:Organization
Organization Name:ALMOND ROAD. SENIOR ESTATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:OLIVIA
Authorized Official - Middle Name:LOANA
Authorized Official - Last Name:RUSU
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-BC
Authorized Official - Phone:510-886-0341
Mailing Address - Street 1:17635 ALMOND RD
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94546-1205
Mailing Address - Country:US
Mailing Address - Phone:510-886-0341
Mailing Address - Fax:510-200-9191
Practice Address - Street 1:17635 ALMOND RD
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94546-1205
Practice Address - Country:US
Practice Address - Phone:510-886-0341
Practice Address - Fax:510-200-9191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-10
Last Update Date:2016-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0156013653104A0625X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness