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EMERALD BLOSSOM MANOR, LLC.
NPI 1346714425
Intermediate Care Facility, Intellectual Disabilities in San Jose, CA

Active since January 11, 2019
5301 GERINE BLOSSOM DR, SAN JOSE, CA 95123(669) 234-3344(669) 500-7377 Get Directions Write a Review

NPPES record last updated: January 11, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Emerald Blossom Manor, Llc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EMERALD BLOSSOM MANOR, LLC. (NPI 1346714425) is a healthcare organization registered as an intermediate care facility, intellectual disabilities in San Jose, California and active in the NPI registry since January 2019. The organization lists Wayne Vincent Kilthau, Licensee, as its authorized official.

NPPES Registry Identity

NPI1346714425
Entity TypeOrganization
Primary Taxonomy315P00000X
Legal Business NameEMERALD BLOSSOM MANOR, LLC.
Location Address5301 GERINE BLOSSOM DRSan Jose, CA 95123-2118
Mailing Address5301 Gerine Blossom DrSan Jose, CA 95123-2118 · (669) 234-3344 · Fax (669) 500-7377
Phone(669) 234-3344
Fax(669) 500-7377
Organization SubpartNo
Authorized OfficialWayne Vincent KilthauLicensee · (669) 234-3344
Enumeration DateJanuary 11, 2019
✔ NPI 1346714425 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIntermediate Care Facility, Intellectual DisabilitiesNursing & Custodial Care Facilities
Taxonomy Code315P00000X
Definition
An intermediate care facility providing services for individuals with intellectual disabilities.
5301 GERINE BLOSSOM DR, San Jose, CA 95123
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WAYNE KILTHAU
Psychologist (Intellectual and Developmental Disabilities)
5301 GERINE BLOSSOM DR
SAN JOSE, CA 95123
Santa Clara County (408) 799-1981

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Emerald Blossom Manor, LLC.'s NPI number?

The NPI number for Emerald Blossom Manor, LLC. is 1346714425. It was assigned to this organization in the NPPES registry on January 11, 2019.

Where is Emerald Blossom Manor, LLC. located?

Emerald Blossom Manor, LLC. is located at 5301 Gerine Blossom Dr, San Jose, CA 95123. The listed phone number is (669) 234-3344.

What is Emerald Blossom Manor, LLC.'s specialty?

The primary specialty registered for this NPI is Intermediate Care Facility, Intellectual Disabilities with taxonomy code 315P00000X.

When was this NPI record last updated?

The NPPES record for Emerald Blossom Manor, LLC. was last updated on January 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.