Healthcare Provider Details

I. General information

NPI: 1205602182
Provider Name (Legal Business Name): HELIOS HEALTHCARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2023
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7590 SHORELINE DR
STOCKTON CA
95219-5455
US

IV. Provider business mailing address

PO BOX 7095
STOCKTON CA
95267-0095
US

V. Phone/Fax

Practice location:
  • Phone: 209-955-2339
  • Fax:
Mailing address:
  • Phone: 209-955-2339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE SMITH
Title or Position: EXECUTIVE DIRECTOR AR & REIMB.
Credential:
Phone: 209-955-2364