# ST JOHN RETIREMENT VILLAGE

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Stollwood Convalescent Hospital
- **Organization subpart:** No

## Provider details

- **NPI number:** 1891914784
- **Authorized official:** MRS. MARIA BURTON (ADMINISTRATOR)
- **Authorized official phone:** (530) 662-1290

## Contact information

- **Practice address:** 135 WOODLAND AVE, WOODLAND, CA 95695-2701
- **Practice address phone:** (530) 662-1290
- **Practice address fax:** (530) 662-4639
- **Mailing address:** 135 WOODLAND AVE, WOODLAND, CA 95695-2701
- **Mailing address phone:** (530) 662-1290
- **Mailing address fax:** (530) 662-4639

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 100000099 | CA | Yes |

## Other

- **Enumeration date:** 04/25/2007
- **Last updated:** 02/08/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 206571047 | — | CA |