# GOOD SAMARITAN CARE PROVIDER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FOUR SEASONS IN PARADISE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1033516539
- **Authorized official:** MS. PRAXEDES BERNARDO DEMESA NHA (PRESIDENT/MANAGING MEMBER)
- **Authorized official phone:** (530) 877-7676

## Contact information

- **Practice address:** 10740 OAKWILDE AVE, STOCKTON, CA 95212-9249
- **Practice address phone:** (209) 406-6610
- **Practice address fax:** (209) 451-4997
- **Mailing address:** 7419 SKYWAY, PARADISE, CA 95969-3230
- **Mailing address phone:** (209) 406-6610
- **Mailing address fax:** (209) 451-4997

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 11/26/2014
- **Last updated:** 11/26/2014