Provider Demographics
NPI:1245380146
Name:MOURI MANAGEMENT GROUP INCORPORATED
Entity Type:Organization
Organization Name:MOURI MANAGEMENT GROUP INCORPORATED
Other - Org Name:SHINRAI HOMES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:
Authorized Official - Last Name:DE JESUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-531-9126
Mailing Address - Street 1:3220 FLINTDALE DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-1231
Mailing Address - Country:US
Mailing Address - Phone:408-531-9126
Mailing Address - Fax:408-531-9020
Practice Address - Street 1:394 GRIDLEY ST
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-1522
Practice Address - Country:US
Practice Address - Phone:408-729-5717
Practice Address - Fax:408-729-5717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
315P00000X
CALTC80244F320600000X, 320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities