Sky Park Health Care Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SKY PARK HEALTH CARE INC.

Doing business as

Acacia Park Nursing & Rehab Cetner

Practice address

1611 Scenic Dr
Modesto, CA 95355-4907

Phone

(209) 523-5667

Fax

(209) 523-6529

NPI assigned

Dec 13, 2006

Organization subpart

No

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

Authorized official

Name

Teresa J Pallivathucal, RN

Title

Administrator

Phone

(209) 523-5667

Specialties & licenses 1

Addresses

Other names 1

• Acacia Park Nursing & Rehab Cetner Doing business as

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1427110055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554907",
            "telephone_number": "209-523-5667",
            "fax_number": "209-523-6529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 SCENIC DR",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953554907",
            "telephone_number": "209-523-5667",
            "fax_number": "209-523-6529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKY PARK HEALTH CARE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "PALLIVATHUCAL",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "209-523-5667",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acacia Park Nursing & Rehab Cetner",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Paulo Sitagata, PT, DPT, FAFS
• Albert K.Q. Siu, M.D.
• Rajaratnam Skantharaja, MD
• Lyndsay Skeen
• Marek Tadeusz Skowron, M.D.
• Sabrina Slater
• Nichole Eleanor Slaughter, PA-C
• Dorothy Joan Slayter, RN BSN RNFA
• Gerad Slayton, CHW, CMPSS, BCST,MHF
• Lee Ann Slaytonbrautovich, LEE

• Skilled Nursing Facility in Modesto, CA
• Providers in Modesto, 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 Jul 21, 2022; 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.