Organization · Type 2 NPI

Shirley's Icf DD N No 5

Nursing Facility/Intermediate Care Facility · Stockton, CA

NPI number 1053563536 Active

Practice location

9565 Colington Pl
Stockton, CA 95209-5013

Call (209) 952-6027 Map

Fax (209) 952-7829

Mailing address

1182 Duvall Ct
Stockton, CA 95210-3581

Specialties and licenses

Taxonomy	Code	License
Nursing Facility/Intermediate Care Facility Primary	313M00000X	5500000686 (CA)

Nursing Facility/Intermediate Care Facility: An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical conditi…

2 other providers at this address

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About NPI 1053563536

Shirley's Icf DD N No 5's National Provider Identifier is 1053563536, issued on Oct 16, 2008. The primary taxonomy on file is Nursing Facility/Intermediate Care Facility (313M00000X), and the practice location is in Stockton, CA. The record was last updated on Oct 16, 2008.