STOCKTON HERITAGE PARTNERS, LLC (NPI# 1619114881) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619114881 |
| Entity Type | Organization |
| Organization Name | STOCKTON HERITAGE PARTNERS, LLC |
| Practice Address |
3530 Deer Park Dr Stockton CA 95219-2350 |
| Mailing Address |
400 Centre St Newton MA 02458-2094 |
| Practice Telephone | 2099516500 |
| Enumeration Date | 2009-01-09 |
| Last Update Date | 2016-06-27 |
| Authorized Official Name | BRUCE J MACKEY JR. (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6177968214 |
| Is Organization Subpart | Y |
| Parent Organization Name | FIVE STAR QUALITY CARE-NE, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Street Address |
3530 DEER PARK DR |
| City | STOCKTON |
| State | CA |
| Zip Code | 95219-2350 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275180440 | Snh Cal Tenant LLC | Assisted Living Facility | 3530 Deer Park Dr, Stockton, CA 95219-2350 | 2019-08-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821568494 | Vanessa Paola Uribe Morales | Behavior Technician | 3620 Hammer Lane, Stockton, CA 95219 | 2018-11-27 |
| 1306316930 | Zulema Cecilia Santana | Behavior Technician | 3620 W. Hammer Ln, Stockton, CA 95219 | 2018-11-27 |
| 1699245241 | Tiana Gonzalez | Behavior Technician | 3620 W. Hammer Ln., Stockton, CA 95219 | 2018-11-27 |
| 1609346220 | Kelly Morales | Behavior Technician | 3620 W Hammer Lane, Stockton, CA 95219 | 2018-11-26 |
| 1336619956 | Mouagoleah Her | Behavior Technician | 3620 W. Hammer Lane, Stockton, CA 95219 | 2018-11-26 |
| 1750837985 | Alexsandra Trejo | Marriage & Family Therapist | 6707 Embarcadero Drive, Stockton, CA 95219 | 2016-08-28 |
| 1659764397 | Integrated Pain Treatment Center | Pain Medicine | 4312 Feather River Drive, Suite C, Stockton, CA 95219 | 2015-03-05 |
| 1790180859 | Mary Karen Papagolos | Marriage & Family Therapist | 2800 W March Ln Ste 473, Stockton, CA 95219 | 2014-10-30 |
| 1932535648 | Morton Rothbard | Urology | 4673 Pine Valley Cir., Stockton, CA 95219 | 2013-09-26 |
| 1033482591 | Michelle M Rutherford | Physical Therapist | 10200 Trinity Pkwy Ste 205, Stockton, CA 95219 | 2012-02-14 |
| Find all providers in zip 95219 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407489966 | Hollywood Rcfe, LLC | Assisted Living Facility | 2306 Hollywood Dr, Stockton, CA 95210-1626 | 2020-02-12 |
| 1942606108 | Brandon Lee Rose | Assisted Living Facility | 9207 Mammath Peak Cir, Stockton, CA 95212-3212 | 2014-11-14 |
| 1316354459 | Good Samaritan Carechoice & Compliance Group LLC | Assisted Living Facility | 5315 Barbados Cir, Stockton, CA 95210-6608 | 2014-07-22 |
| 1477809259 | Mgsact, Inc. | Assisted Living Facility | 517 East Fulton Street, Stockton, CA 95204-2227 | 2012-07-30 |
| 1083899660 | Country Palms Care Home | Assisted Living Facility | 2905 Bristol Ave, Stockton, CA 95204-3935 | 2008-01-02 |
| 1376723973 | Icare Manor, Inc. | Assisted Living Facility | 1215 W Swain Rd, Stockton, CA 95207-4228 | 2007-11-12 |
| 1982803961 | Villa Marche | Assisted Living Facility | 1119 Rose Marie Ln, Stockton, CA 95207 | 2007-07-11 |
| 1023225372 | Tru Health Inc | Assisted Living Facility | 2324 Lever Blvd, Stockton, CA 95206-2900 | 2007-05-17 |
| 1639205925 | Covenant Care, Inc | Assisted Living Facility | 2435 Wagner Heights Rd, Stockton, CA 95209-1778 | 2007-02-23 |
| 1407997281 | Mgsact Inc | Assisted Living Facility | 517 E Fulton St, Stockton, CA 95204 | 2007-02-12 |
| 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.