# BRODY BAY HEALTHCARE, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487476024
- **Authorized official:** SOON BURNAM (SECRETARY)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 900 N CHURCH ST, LODI, CA 95240-1282
- **Practice address phone:** (209) 333-1222
- **Mailing address:** 900 N CHURCH ST, LODI, CA 95240-1282

## Taxonomy

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

## Other

- **Enumeration date:** 10/25/2024
- **Last updated:** 10/25/2024