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Organization
BECHTHOLD CONVALESCENT HOSPITAL, INC
Active
Organization
BECHTHOLD CONVALESCENT HOSPITAL, INC
Active
Other names
Crescent Court Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY BANE (CHIEF OPERATING OFFICIER)
(530) 897-5100
Entity
Organization
Contact information
Practice address
610 S FAIRMONT AVE, LODI, CA 95240-3835
(209) 367-7400
(209) 368-4491
Mailing address
610 S FAIRMONT AVE, LODI, CA 95240-3835
(209) 367-7400
(209) 368-4491
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100000014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR55079I
—
CA
Enumeration date
08/03/2005
Last updated
10/29/2013
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