Organization
TY FIVE STAR CORPORATION
Active
Other names
All Saints Subacute and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES PREIMESBERGER (PRESIDENT)
(213) 709-4887
Entity
Organization
Contact information
Practice address
1652 MONO AVE, SAN LEANDRO, CA 94578-2020
(510) 317-7360
Mailing address
5000 EXECUTIVE PKWY, SUITE 150, SAN RAMON, CA 94583-4210
(925) 855-0881
(925) 855-9297
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
020000050
CA
332BN1400X
Nursing Facility Supplies (DME)
020000050
CA
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
020000050
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020000050
SNF LICENSE NUMBER
CA
Enumeration date
03/02/2007
Last updated
02/13/2014
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