| Organization Name: | LIVE OAK ADULT DAY SERVICES |
| NPI Number: | 1003165341 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | COLLEEN HUDGEN (EXECUTIVE DIRECTOR) |
| Mailing Address: | 1147 Minnesota Ave San Jose |
| State: | CA US |
| Postal Code: | 951253324 |
| Phone Number: | 4089719363 |
| Fax Number: | 4089719079 |
| NPI Enumeration Date: | 08/31/2012 |
| NPI Last Update Date: | 08/31/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 385H00000X |
| License Number: | 435200743 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respite Care Facility |
| Taxonomy Classification: | Respite Care |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |