Organization
GOOD SAMARITAN CARE PROVIDER LLC
Active
Other names
FOUR SEASONS IN PARADISE
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PRAXEDES BERNARDO DEMESA NHA (PRESIDENT/MANAGING MEMBER)
(530) 877-7676
Entity
Organization
Contact information
Practice address
10740 OAKWILDE AVE, STOCKTON, CA 95212-9249
(209) 406-6610
(209) 451-4997
Mailing address
7419 SKYWAY, PARADISE, CA 95969-3230
(209) 406-6610
(209) 451-4997
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
11/26/2014
Last updated
11/26/2014
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