Provider Demographics
NPI:1275703571
Name:A & C HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:A & C HEALTH CARE SERVICES, INC.
Other - Org Name:A & C CONVALESCENT HOSPITAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:C.F.O.
Authorized Official - Prefix:MRS
Authorized Official - First Name:AMPARO
Authorized Official - Middle Name:B
Authorized Official - Last Name:RAGUDO
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:408-226-0300
Mailing Address - Street 1:5615 COTTLE RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95123-3625
Mailing Address - Country:US
Mailing Address - Phone:408-226-0300
Mailing Address - Fax:408-226-3800
Practice Address - Street 1:33 MATEO AVE
Practice Address - Street 2:
Practice Address - City:MILLBRAE
Practice Address - State:CA
Practice Address - Zip Code:94030-2037
Practice Address - Country:US
Practice Address - Phone:650-583-8937
Practice Address - Fax:650-583-2647
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A & C HEALTH CARE SERVICES, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-03
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA220000050314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA05-6122 ZZR06122GOtherPROVIDER NUMBER
CA05-6122 ZZR06122GMedicaid
CA05-6122 ZZR06122GOtherPROVIDER NUMBER