A Broader Living Experience
A Broader Living Experience is an Intellectual Disabilities Intermediate Care Facility in San Rafael, California. Licensed in California. Registered with an NPI since 2007.
- Licensed in
- CA
- In the registry since
- 2007
Practice location Address checks out
25 De Anza WaySan Rafael, CA 94903-3868
Phone: (415) 492-8087
Fax: (415) 492-0347
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual Disabilities Intermediate Care Facility (primary) | Taxonomy 315P00000X · Licence LTC60124G (CA) |
|---|
Record details
| NPI number | 1528278371 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Terry Jones — Board Secretary Treasurer · (415) 492-8087 |
| Other names | Able |
| NPI enumerated | May 23, 2007 |
| Last updated in NPPES | June 13, 2008 |
| Mailing address | 25 De Anza Way, San Rafael, CA 94903-3868 |
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