NPIMap

Organization Active NPI

Lifemoves - Autumn Satellite Clinic

  • Case Management Agency
  • San Jose, CA
National Provider Identifier
1366895666
Registry record updated Jun 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
LIFEMOVES - AUTUMN SATELLITE CLINIC
Practice address
263 N Autumn St
San Jose, CA 95110
Phone
(650) 685-5880
NPI assigned
Jul 21, 2016
Organization subpart
Yes
Parent organization
LIFEMOVESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2018

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

Authorized official

Name
Mr. Craig Garber
Title
Cfo
Phone
(650) 685-5880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

263 N Autumn St
San Jose, CA 95110

Mailing address

181 Constitution Dr
Menlo Park, CA 94025-1106
Phone (650) 685-5880

National Provider Directory

National Provider Directory
Tax ID family
Lifemoves - Julian Street Inn4 organizations share this tax ID, including this one
Part of
Lifemoves - Julian Street Inn

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

181 Constitution Dr
Menlo Park, CA 94025

NPI Registry JSON

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527811200000",
    "number": "1366895666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 CONSTITUTION DR",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940251106",
            "telephone_number": "650-685-5880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 N AUTUMN ST",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "95110",
            "telephone_number": "650-685-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEMOVES - AUTUMN SATELLITE CLINIC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFEMOVES",
        "enumeration_date": "2016-07-21",
        "last_updated": "2018-06-01",
        "status": "A",
        "authorized_official_last_name": "GARBER",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "650-685-5880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 1, 2018; 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.