Black Mountain, LLC
NPI #1396110219 in San Mateo, California
Provider Information
- NPI Number
- 1396110219
- Entity Type
- Organization
- Organization Name
- Black Mountain, LLC
- Primary Specialty
- Home Health
- Enumeration Date
- Dec 3, 2015
- Last Updated
- Dec 3, 2015
Practice Location
- Address
- 177 BOVET RD
- Address 2
- SUITE 130
- City
- San Mateo
- State
- California
- ZIP Code
- 94402-3116
- Phone
- (650) 785-2800
Authorized Official
- Name
- JAKE CARUSO
- Title
- MANAGING DIRECTOR
- Phone
- (650) 785-2800
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
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