Organization Active NPI

Hearts & Minds Activity Center

  • Respite Care
  • San Jose, CA
National Provider Identifier
1144569039
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
Legal business name
HEARTS & MINDS ACTIVITY CENTER
Practice address
2380 Enberg Lane
San Jose, CA 95128-2146
Phone
(408) 279-7515
Fax
(408) 279-7519
NPI assigned
Feb 12, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Maria Angelica Nicolacoudis, MA
Title
Ceo
Phone
(408) 279-7515

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Day Care Clinic/Center 261QA0600X 435202011 CA
Respite Care 385H00000X Primary

Addresses

Primary practice location

2380 Enberg Lane
San Jose, CA 95128-2146

Mailing address

2380 Enberg Lane
San Jose, CA 95128-2146
Phone (408) 279-7515

Other names 1

  • Respite and Research for Alzheimers Disease Former legal business name

National Provider Directory

National Provider Directory

Locations

2380 Enborg Ln
San Jose, CA 95128
Phone (408) 279-7515

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1360627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1144569039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 ENBERG LANE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282146",
            "telephone_number": "408-279-7515",
            "fax_number": "408-279-7519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 ENBERG LANE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951282146",
            "telephone_number": "408-279-7515",
            "fax_number": "408-279-7519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTS & MINDS ACTIVITY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-12",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "NICOLACOUDIS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "ANGELICA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "408-279-7515",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "CA",
            "license": "435202011",
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Respite and Research for Alzheimers Disease",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.