Gross Convalescent Hospital, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

GROSS CONVALESCENT HOSPITAL, INC

Doing business as

Wine Country Care Center

Practice address

321 W Turner Rd
Lodi, CA 95240-0517

Phone

(209) 334-3760

Fax

(209) 334-1071

NPI assigned

Jul 28, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Paul G Gross, M.A.

Title

Administrator/Ceo

Phone

(209) 334-3760

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• WINE COUNTRY CARE CENTER Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053311225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 W TURNER RD",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952400517",
            "telephone_number": "209-334-3760",
            "fax_number": "209-334-1071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 W TURNER RD",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952400517",
            "telephone_number": "209-334-3760",
            "fax_number": "209-334-1071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROSS CONVALESCENT HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "ADMINISTRATOR/CEO",
        "authorized_official_telephone_number": "209-334-3760",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.A."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05289F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "WINE COUNTRY CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abigail Breann Graves
• Catherine Ann Gravish, P.T.
• Rabeep Kaur Grewal, M.D.
• Ravleen Kaur Grewal
• Teri Christine Grisler, CMT
• Joanna Grubbs, PHARM.D.
• Guardians of Home Care LLC
• Irene Guel
• Ashleigh Marie Guilbeau, M.D.
• Christian Guillory

• Skilled Nursing Facility in Lodi, CA
• Providers in Lodi, CA by specialty
• Skilled Nursing Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.