# STOCKTON EDISON HEALTHCARE CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GOOD SAMARITAN REHAB & CARE CENTER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548283542
- **Authorized official:** MS. PRAXEDES DEMESA BERNABE NHA (PRESIDENT)
- **Authorized official phone:** (209) 948-8762

## Contact information

- **Practice address:** 1630 N. EDISON ST., STOCKTON, CA 95204
- **Practice address phone:** (209) 948-8762
- **Practice address fax:** (209) 948-8503
- **Mailing address:** 1630 N. EDISON STREET, STOCKTON, CA 95204
- **Mailing address phone:** (209) 948-8762
- **Mailing address fax:** (818) 541-7072

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 230000012 | CA | — |
| 314000000X | Skilled Nursing Facility | — | CA | Yes |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 11/29/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR05039J | — | CA |