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Organization

LODI SKILLED NURSING SERVICES, INC.

Active
Other names
Fairmont Rehabilitation Hospital
Organization subpart
No

Provider details

NPI number
Authorized official
MARC JOHNSON (CFO)
(949) 373-8373
Entity
Organization

Contact information

Practice address
950 S FAIRMONT AVE, LODI, CA 95240
(209) 368-0693
(209) 339-9759
Mailing address
25910 ACERO STE 350, MISSION VIEJO, CA 92691-7908
(949) 441-9258

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
100000039
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ZZR05242I
CA
Enumeration date
05/26/2006
Last updated
04/05/2024
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