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General NPI Number Information
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NPI Number | 1962551713
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Entity Type | Organization
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Legal Business Name | DUKE FACILITIES, INC
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 403 GOYA DR
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City | STOCKTON
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State | CA
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Zip | 95207-2246
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Country | US
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Telephone | 209-472-7848
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Fax |
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Provider Business Mailing Address
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Address Line | 1150 W ROBINHOOD DR STE 2C
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City | STOCKTON
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State | CA
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Zip | 95207-5624
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Country | US
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Telephone |
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Fax | 209-474-9260
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Authorized Official
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Title or Position | LICENSEE PRESIDENT
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Name | MRS. ANITA BETH DUKE
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Credential | R.N.P.
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Telephone | 209-969-1576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 315P00000X
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Taxonomy Name | Intellectual Disabilities Intermediate Care Facility
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License Number | 55G532
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License Number State | CA
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