Faith Enterprises, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

100000204 Issued in CA

Legal business name

FAITH ENTERPRISES, INC

Doing business as

Tracy Convalescent and Rehabilitation Center

Practice address

545 W Beverly PL
Tracy, CA 95376-3012

Phone

(209) 835-6034

Fax

(209) 835-3339

NPI assigned

Oct 6, 2006

Organization subpart

No

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

Authorized official

Name

Mr. R. David Delisle, NHA

Title

Administrator

Phone

(209) 835-6034

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tracy Convalescent and Rehabilitation Center Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randall David Delisle

  • Marriage & Family Therapist
  • San Luis Obispo, CA
  • NPI 1972995330
  NPD

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1346337896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 W BEVERLY PL",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763012",
            "telephone_number": "209-835-6034",
            "fax_number": "209-835-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 W BEVERLY PL",
            "city": "TRACY",
            "state": "CA",
            "postal_code": "953763012",
            "telephone_number": "209-835-6034",
            "fax_number": "209-835-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAITH ENTERPRISES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "DELISLE",
        "authorized_official_first_name": "R.",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-835-6034",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NHA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "100000204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR55080I",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tracy Convalescent and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Maja Michelle Everson, MD
• Evolve Family Therapy PC
• Fadli Home Care Inc (Fadli home care)
• Patrick Victor Faggianelli Jr., PH.D.
• Maria Faheem
• Amanie Falol
• Family Optometry of Tracy Inc
• Sahel Farhangi, D.D.S.
• Angelica Farias
• Eshna Fatima

• Skilled Nursing Facility in Tracy, CA
• Providers in Tracy, 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 Feb 26, 2010; 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.