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Organization
STOCKTON CONGREGATIONAL HOMES
Active
Organization
STOCKTON CONGREGATIONAL HOMES
Active
Other names
PLYMOUTH SQUARE
Organization subpart
No
Provider details
NPI number
Authorized official
STUART HARTMAN (V.P. OF OPERATIONS)
(562) 257-5100
Entity
Organization
Contact information
Practice address
1319 N MADISON ST, STOCKTON, CA 95202-1047
(209) 466-4341
(209) 466-8853
Mailing address
1319 N MADISON ST, STOCKTON, CA 95202-1047
(209) 466-4341
(209) 466-8853
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100000076
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255336533
—
CA
01
—
390300536
RCFE
CA
Enumeration date
06/14/2005
Last updated
09/16/2014
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