Organization
BETHANY HOME SOCIETY OF SAN JOAQUIN COUNTY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW LEE (EXECUTIVE DIRECTOR)
(209) 599-4221
Entity
Organization
Contact information
Practice address
930 W MAIN ST, RIPON, CA 95366-2325
(209) 599-4221
(209) 599-7332
Mailing address
930 W MAIN ST, RIPON, CA 95366-2325
(209) 599-4221
(209) 599-7332
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100000015
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZZR05662F
—
CA
Enumeration date
09/08/2005
Last updated
03/11/2009
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