Provider Demographics
NPI:1912423203
Name:LADWIG INC
Entity Type:Organization
Organization Name:LADWIG INC
Other - Org Name:COMPASSIONATE ELDERCARE UNDAJON RCFE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:JUVELYN IRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:LADWIG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-821-2630
Mailing Address - Street 1:3340 PINKERTON DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95148-2753
Mailing Address - Country:US
Mailing Address - Phone:408-821-2630
Mailing Address - Fax:
Practice Address - Street 1:683 UNDAJON DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95133-1736
Practice Address - Country:US
Practice Address - Phone:408-937-1542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA435202568310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility