SOLIDUM CARE HOME ICF/DD-N #3 (NPI# 1730596214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730596214 |
| Entity Type | Organization |
| Organization Name | SOLIDUM CARE HOME ICF/DD-N #3 |
| Practice Address |
8712 Ensenada Dr Stockton CA 95210-1213 |
| Mailing Address |
9559 Colington Pl Stockton CA 95209-5013 |
| Practice Telephone | 2094760541 |
| Mailing Telephone | 2094746785 |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |
| Authorized Official Name | NORMA SOLIDUM (CORPORATE OFFICER) |
| Authorized Official Telephone | 2094746785 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOLIDUM CARE HOMES, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 313M00000X | Nursing Facility/Intermediate Care Facility | CA | Nursing & Custodial Care Facilities |
| Street Address |
8712 ENSENADA DR |
| City | STOCKTON |
| State | CA |
| Zip Code | 95210-1213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063021970 | Leslie Jazmin Marin | Student in an Organized Health Care Education/Training Program | 7109 Danny Dr, Stockton, Stockton, CA 95210 | 2020-07-27 |
| 1043866692 | Alexis Thomasson | Behavior Technician | 7109 Danny Drive, Stockton, CA 95210 | 2019-08-09 |
| 1821651324 | Maria Guadalupe Toledo | Lactation Consultant, Non-RN | 7912 Hammer Lane, Stockton, CA 95210 | 2019-04-19 |
| 1508226440 | Active Life Adult Day Care, Inc. | Clinic/Center | 7209 Tam O'shanter Dr., Stockton, CA 95210 | 2016-03-04 |
| 1548631260 | Rachel Standley | Substance Abuse Rehabilitation Facility | 8017 El Cajon St, Stockton, CA 95210 | 2015-10-08 |
| 1225435308 | Active Life Medical Produtcs Inc | Durable Medical Equipment & Medical Supplies | 611 W Grider Way, Stockton, CA 95210 | 2014-12-04 |
| 1942633318 | Kimberly Ruiz Dizon | Physician Assistant | 1530 E Hammer Ln, Stockton, CA 95210 | 2013-08-20 |
| 1285920983 | Supplemental Health Care | Preferred Provider Organization | 8425 Kiltie Wy, Stockton, CA 95210 | 2011-06-22 |
| 1770807901 | Stockton Medical Weight Loss Center Inc | Internal Medicine | 1801 E. March Lane, Suite 400d, Stockton, CA 95210 | 2010-03-17 |
| 1699911412 | Pratap Krishna Anne | Pharmacist | 1801 E.march Ln, Suite:b280, Bjrx, Stockton, CA 95210 | 2008-12-29 |
| Find all providers in zip 95210 | ||||
| Taxonomy Code | 313M00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | 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 condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. |
| Notes: Source: Paraphrased from Section 1919 (a) of the Social Security Act. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205224334 | Angel's Home Icf, Inc. | Nursing Facility/Intermediate Care Facility | 10712 Waterbury Dr, Stockton, CA 95209-4212 | 2014-12-23 |
| 1992057244 | Solidum Care Home Icfdd-n#2 | Nursing Facility/Intermediate Care Facility | 9559 Colington Pl, Stockton, CA 95209-5013 | 2012-10-11 |
| 1750687687 | Dhk Manor, Inc | Nursing Facility/Intermediate Care Facility | 4513 Augustus Ct, Stockton, CA 95207-6632 | 2011-02-10 |
| 1285821272 | Solidum Care Homes | Nursing Facility/Intermediate Care Facility | 3522 Otto Dr, Stockton, CA 95209-5138 | 2007-10-03 |
| 1659596856 | Casa Del Rios | Nursing Facility/Intermediate Care Facility | 5541 Solari Ranch Rd, Stockton, CA 95215-9318 | 2007-04-15 |
| 1417009507 | Shirley's Care Home | Nursing Facility/Intermediate Care Facility | 9565 Colington Pl, Stockton, CA 95209-5013 | 2007-01-17 |
| 1700935509 | Duke Facilities, Inc. | Nursing Facility/Intermediate Care Facility | 2661 Otto Dr, Stockton, CA 95209-1111 | 2007-01-09 |
| 1194836163 | City of Stockton | Nursing Facility/Intermediate Care Facility | 315 S Ash St, Stockton, KS 67669-2136 | 2006-08-31 |
| 1124442520 | Solidum Care Home Icf Ddn2 | Nursing Facility/Intermediate Care Facility | 9559 Colington Pl, Stockton, CA 95209-5013 | 2014-02-06 |
| 1053563536 | Shirley's Icf Dd N No 5 | Nursing Facility/Intermediate Care Facility | 9565 Colington Pl, Stockton, CA 95209-5013 | 2008-10-16 |
| 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.