STOCKTON CONGREGATIONAL HOMES (NPI# 1255336533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255336533 |
| Entity Type | Organization |
| Organization Name | STOCKTON CONGREGATIONAL HOMES |
| Other Organization Name | PLYMOUTH SQUARE |
| Practice Address |
1319 N Madison St Stockton CA 95202-1047 |
| Practice Telephone | 2094664341 |
| Practice Fax Number | 2094668853 |
| Mailing Telephone | 2094664341 |
| Mailing Fax Number | 2094668853 |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2014-09-16 |
| Authorized Official Name | STUART HARTMAN (V.P. OF OPERATIONS) |
| Authorized Official Telephone | 5622575100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 100000076 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 1255336533 | 05 | |
| CA | RCFE | 390300536 | 01 |
| Other Name | Type Code |
|---|---|
| PLYMOUTH SQUARE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447662507 | Stockton Congregational Homes | Assisted Living Facility | 1319 N Madison St, Stockton, CA 95202-1001 | 2014-05-23 |
| Street Address |
1319 N MADISON ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95202-1047 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114400827 | Mary Jane Jane Tiples | Physical Therapist | 1319 N Madison St, Stockton, CA 95202-1001 | 2018-09-09 |
| 1164948824 | Martha Sakakura | Occupational Therapist | 1319 N Madison St, Stockton, CA 95202-1001 | 2017-08-15 |
| 1447662507 | Stockton Congregational Homes | Assisted Living Facility | 1319 N Madison St, Stockton, CA 95202-1001 | 2014-05-23 |
| 1659697860 | Jose Rey Gonzales | Physical Therapist | 1319 N Madison St, Stockton, CA 95202-1047 | 2010-04-13 |
| 1992035927 | Kiran Rambhatla | Physical Therapist | 1319 N Madison St, Stockton, CA 95202-1047 | 2010-01-14 |
| 1770761108 | Jill Albinto Gonzales | Occupational Therapist | 1319 N Madison St, Plymouth Square, Stockton, CA 95202 | 2008-02-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336774678 | Lecletus Griffin Jr. | Counselor | 1212 N. Califronia Street, Stockton, CA 95202 | 2020-03-06 |
| 1861035586 | Andrea Mn Perkins | Social Worker | Sjc Bhs Bacop, 1149 El Dorado Street, Stockton, CA 95202 | 2019-10-25 |
| 1932664620 | San Joaquin County Behavioral Health Services | Community/Behavioral Health | 1212 N. Califorian St, Stockton, CA 95202 | 2019-02-06 |
| 1730655895 | Jenaiah La'neise Sauceda | Social Worker | 343 E Main St Ste 918, Stockton, CA 95202 | 2018-10-16 |
| 1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
| 1912406976 | Janet Mendoza | Social Worker | 6 South Eldorado Street, Stockton, CA 95202 | 2018-02-06 |
| 1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
| 1124545355 | Suleyma Velesquez | Counselor | 445 N. San Joaquin St., Stockton, CA 95202 | 2017-08-28 |
| 1821513946 | Savoeun Phal | Counselor | 1212 N California St Ste A214, Stockton, CA 95202 | 2017-08-09 |
| 1861921272 | Mandeep K Minhas | Registered Nurse | 1212 California St, Stockton, CA 95202 | 2017-06-08 |
| Find all providers in zip 95202 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316330152 | Waverly Place of Stockton, LLC | Skilled Nursing Facility | 501 E Front Avenue, Stockton, IL 61085 | 2015-03-17 |
| 1932507431 | Sandra Rae Divine | Skilled Nursing Facility | 1015 Lancaster Dr, Stockton, MO 65785-8360 | 2014-12-15 |
| 1114323136 | Good Samaritan Care Provider LLC | Skilled Nursing Facility | 10740 Oakwilde Ave, Stockton, CA 95212-9249 | 2014-11-19 |
| 1801938816 | Covenant Care California, LLC | Skilled Nursing Facility | 9289 Branstetter Place, Stockton, CA 95209-1700 | 2007-02-13 |
| 1730269184 | O'connor Woods Housing Corp | Skilled Nursing Facility | 3110 Wagner Heights Rd, Stockton, CA 95209-4848 | 2006-10-17 |
| 1891700464 | Kindred Nursing Centers West, LLC | Skilled Nursing Facility | 1517 E Knickerbocker Dr, Stockton, CA 95210-3119 | 2006-07-30 |
| 1548283542 | Stockton Edison Healthcare Corporation | Skilled Nursing Facility | 1630 N. Edison St., Stockton, CA 95204 | 2006-07-25 |
| 1871512046 | Helios Healthcare, LLC | Skilled Nursing Facility | 442 E Hampton St, Stockton, CA 95204-5519 | 2006-07-19 |
| 1922027002 | Helios Healthcare, LLC | Skilled Nursing Facility | 6940 Pacific Ave, Stockton, CA 95207-2602 | 2006-07-19 |
| 1487601704 | Sunbridge Stockton Rehabilitation Center LLC | Skilled Nursing Facility | 9107 Davis Rd, Stockton, CA 95209-1807 | 2006-05-30 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.