# TJD, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Anberry Rehabilitation Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154399244
- **Authorized official:** DONALD WALTER GORMLY (MEMBER)
- **Authorized official phone:** (714) 907-7677

## Contact information

- **Practice address:** 1685 SHAFFER RD, ATWATER, CA 95301-4456
- **Practice address phone:** (209) 357-3420
- **Practice address fax:** (209) 356-2486
- **Mailing address:** 1685 SHAFFER RD, ATWATER, CA 95301-4456
- **Mailing address phone:** (209) 357-3420
- **Mailing address fax:** (209) 356-2486

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 040000070 | CA | Yes |

## Other

- **Enumeration date:** 03/14/2006
- **Last updated:** 11/13/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | LTC55244H | — | CA |
| 01 | — | ZZZM2405Z | BLUE SHIELD | CA |