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Organization
FAITH ENTERPRISES, INC
Active
Organization
FAITH ENTERPRISES, INC
Active
Other names
Tracy Convalescent and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. R. DAVID DELISLE NHA (ADMINISTRATOR)
(209) 835-6034
Entity
Organization
Contact information
Practice address
545 W BEVERLY PL, TRACY, CA 95376-3012
(209) 835-6034
(209) 835-3339
Mailing address
545 W BEVERLY PL, TRACY, CA 95376-3012
(209) 835-6034
(209) 835-3339
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100000204
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR55080I
—
CA
Enumeration date
10/06/2006
Last updated
02/26/2010
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