Provider Demographics
NPI:1982205738
Name:ASM FAMILY FOUNDATION
Entity Type:Organization
Organization Name:ASM FAMILY FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:MARANAN
Authorized Official - Last Name:MACATANGAY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:510-378-5167
Mailing Address - Street 1:4049 1ST ST STE 229
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-5363
Mailing Address - Country:US
Mailing Address - Phone:510-378-5167
Mailing Address - Fax:925-271-5112
Practice Address - Street 1:120 CORNING AVE
Practice Address - Street 2:
Practice Address - City:MILPITAS
Practice Address - State:CA
Practice Address - Zip Code:95035-5225
Practice Address - Country:US
Practice Address - Phone:408-262-0217
Practice Address - Fax:408-262-1619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA55775Medicaid