Provider Demographics
NPI:1790109411
Name:REBEKAH CHILDREN'S SERVICES
Entity Type:Organization
Organization Name:REBEKAH CHILDREN'S SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSTRUCTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:GASCA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-427-1519
Mailing Address - Street 1:419 MADISON CT
Mailing Address - Street 2:
Mailing Address - City:GILROY
Mailing Address - State:CA
Mailing Address - Zip Code:95020-3641
Mailing Address - Country:US
Mailing Address - Phone:408-427-1519
Mailing Address - Fax:
Practice Address - Street 1:290 IOOF AVE
Practice Address - Street 2:
Practice Address - City:GILROY
Practice Address - State:CA
Practice Address - Zip Code:95020-5204
Practice Address - Country:US
Practice Address - Phone:408-846-2100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-17
Last Update Date:2014-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management