# TY FIVE STAR CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** All Saints Subacute and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1235267972
- **Authorized official:** JAMES PREIMESBERGER (PRESIDENT)
- **Authorized official phone:** (213) 709-4887

## Contact information

- **Practice address:** 1652 MONO AVE, SAN LEANDRO, CA 94578-2020
- **Practice address phone:** (510) 317-7360
- **Mailing address:** 5000 EXECUTIVE PKWY, SUITE 150, SAN RAMON, CA 94583-4210
- **Mailing address phone:** (925) 855-0881
- **Mailing address fax:** (925) 855-9297

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 020000050 | CA | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | 020000050 | CA | — |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | 020000050 | CA | — |

## Other

- **Enumeration date:** 03/02/2007
- **Last updated:** 02/13/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 020000050 | SNF LICENSE NUMBER | CA |