Organization
BECHTHOLD CONVALESCENT HOSPITAL, INC
Active
Other names
Crescent Court Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY BANE (CHIEF OPERATING OFFICIER)
(530) 897-5100
Entity
Organization
Contact information
Practice address
610 S FAIRMONT AVE, LODI, CA 95240-3835
(209) 367-7400
(209) 368-4491
Mailing address
610 S FAIRMONT AVE, LODI, CA 95240-3835
(209) 367-7400
(209) 368-4491
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100000014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR55079I
—
CA
Enumeration date
08/03/2005
Last updated
10/29/2013
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