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General NPI Number Information
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NPI Number | 1902788706
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Entity Type | Organization
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Legal Business Name | STANISLAUS SUBACUTE REHAB LLC
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 1421 OAKDALE RD
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City | MODESTO
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State | CA
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Zip | 95355-3356
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Country | US
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Telephone | 209-901-4212
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Fax | 209-901-4218
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Provider Business Mailing Address
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Address Line | PO BOX 4730
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City | MODESTO
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State | CA
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Zip | 95352-4730
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MARIA MUNOZ
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Credential |
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Telephone | 209-901-4212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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