# VINTAGE COURT HEALTHCARE, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104648757
- **Authorized official:** SOON BURNAM (SECRETARY)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 3620-B DALE RD, MODESTO, CA 95356-0598
- **Practice address phone:** (209) 521-2094
- **Mailing address:** 3620 DALE RD, MODESTO, CA 95356-0598

## Taxonomy

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

## Other

- **Enumeration date:** 10/25/2024
- **Last updated:** 02/13/2025