Provider Demographics
NPI:1669677878
Name:SAGAL GROUP CARE, INC
Entity type:Organization
Organization Name:SAGAL GROUP CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMALI
Authorized Official - Middle Name:WARFA
Authorized Official - Last Name:ATTEYEH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-244-7553
Mailing Address - Street 1:2845 MOORPARK AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95128-3158
Mailing Address - Country:US
Mailing Address - Phone:408-244-7553
Mailing Address - Fax:
Practice Address - Street 1:2845 MOORPARK AVE STE 108
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95128-3158
Practice Address - Country:US
Practice Address - Phone:408-244-7553
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2717715320700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities