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General NPI Number Information
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NPI Number | 1417009507
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Entity Type | Organization
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Legal Business Name | SHIRLEY'S CARE HOME
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9565 COLINGTON PL
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City | STOCKTON
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State | CA
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Zip | 95209-5013
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Country | US
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Telephone | 209-607-9380
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Fax | 209-952-7825
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Provider Business Mailing Address
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Address Line | 9565 COLINGTON PL
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City | STOCKTON
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State | CA
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Zip | 95209-5013
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Country | US
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Telephone | 209-607-9380
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Fax | 209-952-7825
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SHIRLEY E GAPASIN
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Credential |
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Telephone | 209-607-9380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number |
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License Number State | CA
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