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Intermediate care facility for individuals with intellectual disabilities in San Jose, CA, Medicare certification number 55G753.
Medicare certification
Provider of Services- CCN
- 55G753
- Status
- Active
- Provider type
- Intermediate care facility for individuals with intellectual disabilities
- Control type
- Private (proprietary)
- Participating since
- Jun 6, 2017
- Last certification
- Nov 20, 2025
- Beds
- 6
- Address
- 2893 Ross Avenue
San Jose, CA 95124
(408) 978-5540
NPI records for this facility 1
-
- Intellectual Disabilities Intermediate Care Facility
- San Jose, CA
- NPI 1518178904
Name & address match
Sources for this page
- Provider of Services: the certification, provider type, beds and status.
- Medicare Care Compare: the star rating and every measure on this page, with the state and national rates CMS publishes beside them.
- NPPES NPI Registry: the NPI records connected to this certification.