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Organization
TY FIVE STAR CORPORATION
Active
Organization
TY FIVE STAR CORPORATION
Active
Other names
All Saints Subacute and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PREIMESBERGER (PRESIDENT)
(213) 709-4887
Entity
Organization
Contact information
Practice address
1652 MONO AVE, SAN LEANDRO, CA 94578-2020
(510) 317-7360
Mailing address
5000 EXECUTIVE PKWY, SUITE 150, SAN RAMON, CA 94583-4210
(925) 855-0881
(925) 855-9297
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
020000050
CA
332BN1400X
Nursing Facility Supplies (DME)
020000050
CA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
020000050
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020000050
SNF LICENSE NUMBER
CA
Enumeration date
03/02/2007
Last updated
02/13/2014
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