Organization
DEERGRASS HEALTHCARE, INC.
Active
Other names
Fairmont Rehabilitation Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (TREASURER)
(949) 540-1249
Entity
Organization
Contact information
Practice address
950 S FAIRMONT AVE, LODI, CA 95240-5131
(209) 368-0693
Mailing address
950 S FAIRMONT AVE, LODI, CA 95240-5131
(209) 368-0693
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/27/2022
Last updated
12/27/2022
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