STOCKTON CONGREGATIONAL HOMES
Skilled Nursing Facility
Stockton, California
Provider NPI: 1255336533
Organization Information:Organization Name: STOCKTON CONGREGATIONAL HOMES
Practice Location:
1319 N MADISON ST STOCKTON, CA 95202 US
Tel: 209-466-4341 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
1319 N MADISON ST STOCKTON, CA 95202 US
Tel: 209-466-4341 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 314000000X | Nursing & Custodial Care Facilities Skilled Nursing Facility | CA | 100000076 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
1255336533 | CA | 05 | |
RCFE | 390300536 | CA | 01 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin