MGSACT, INC. (NPI# 1477809259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477809259 |
| Entity Type | Organization |
| Organization Name | MGSACT, INC. |
| Other Organization Name | STACIE'S CHALET STOCKTON |
| Practice Address |
517 East Fulton Street Stockton CA 95204-2227 |
| Practice Telephone | 2094552115 |
| Practice Fax Number | 2094667265 |
| Mailing Telephone | 2094662116 |
| Mailing Fax Number | 2094667285 |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2013-07-15 |
| Authorized Official Name | MS. YOLANDA B NIXON (ADMINISTRATOR) |
| Authorized Official Telephone | 9163639468 |
| Authorized Official Credential | R.N., O.N.C. |
| Is Organization Subpart | Y |
| Parent Organization Name | MGSACT, INC. |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | 397005060 | Nursing & Custodial Care Facilities | |
| Y | 310400000X | Assisted Living Facility | 347001977 | CA | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RCF00012F | 05 |
| Other Name | Type Code |
|---|---|
| Stacie's Chalet Stockton | Doing Business As Name - Organization |
| Street Address |
517 EAST FULTON STREET |
| City | STOCKTON |
| State | CA |
| Zip Code | 95204-2227 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962027524 | Kariem Abdelwahed | Licensed Vocational Nurse | 1630 N. Edison St Stockton Ca, Stockton, CA 95204 | 2020-06-10 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1235614116 | Michelle Ann Horn | Marriage & Family Therapist | 3666 Mission Rd, Stockton, CA 95204 | 2018-09-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1790228781 | Rebecca Phongsa | Counselor | 1947 North Calfornia Street, Suite B, Stockton, CA 95204 | 2016-11-23 |
| 1700332905 | Serim Kang | Driver | 4222 N Pershing Ave, Suite D2, Stockton, CA 95204 | 2016-08-28 |
| 1033565544 | Philip John Brereton | Orthotist | 466 E Harding Way, Stockton, CA 95204 | 2016-05-13 |
| 1932507522 | David Grayson | Counselor | 1621 Brookside Rd, Stockton, CA 95204 | 2014-12-12 |
| 1174934897 | Gurtej Malhi | Internal Medicine | 1901 N California Street, Stockton, CA 95204 | 2014-05-15 |
| 1396156170 | Rajesh Saini | Nurse Practitioner | 1805 N California St. Suite 102, Stockton, CA 95204 | 2014-05-14 |
| Find all providers in zip 95204 | ||||
| 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 |
| 1619114881 | Stockton Heritage Partners, LLC | Assisted Living Facility | 3530 Deer Park Dr, Stockton, CA 95219-2350 | 2009-01-09 |
| 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.