Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

A Broader Living Experience

Intellectual Disabilities Intermediate Care Facility in San Rafael, CA · enumerated 2007 · authorized official Terry Jones, Board Secretary Treasurer.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1528278371

Verified

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Registry record

Entity type Organization (Type 2)

Legal business name A Broader Living Experience

Other name <Unavail>

Practice address 25 De Anza Way, San Rafael, CA, 94903

Phone (415) 492-8087

Fax (415) 492-0347

Enumeration date May 23, 2007

Last updated in NPPES Jun 13, 2008

Taxonomy & classification

315P00000X Intellectual Disabilities Intermediate Care Facility Nursing & Custodial Care Facilities · License LTC60124G (CA) Primary

Authorized official

Name Terry Jones

Title Board Secretary Treasurer

Phone (415) 492-8087

Other identifiers

Identifier	Type	State	Issuer
LTC60124G	Other	CA	LONG TERM CARE ID

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2008-06-13. Verify at npiregistry.cms.hhs.gov.

Where is A Broader Living Experience located?

The practice location on file with NPPES is in San Rafael, CA.

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2008-06-13.