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Organization
STOCKTON EDISON HEALTHCARE CORPORATION
Active
Organization
STOCKTON EDISON HEALTHCARE CORPORATION
Active
Other names
GOOD SAMARITAN REHAB & CARE CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PRAXEDES DEMESA BERNABE NHA (PRESIDENT)
(209) 948-8762
Entity
Organization
Contact information
Practice address
1630 N. EDISON ST., STOCKTON, CA 95204
(209) 948-8762
(209) 948-8503
Mailing address
1630 N. EDISON STREET, STOCKTON, CA 95204
(209) 948-8762
(818) 541-7072
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
230000012
CA
314000000X
Skilled Nursing Facility
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR05039J
—
CA
Enumeration date
07/25/2006
Last updated
11/29/2011
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