NPIMap

Organization Active NPI

Gapasin Manor Icfddn #1

  • Intellectual Disabilities Intermediate Care Facility
  • Stockton, CA
National Provider Identifier
1568676492
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
LTC80072F Issued in CA
Legal business name
GAPASIN MANOR ICFDDN #1
Practice address
2451 Shropshire Dr
Stockton, CA 95209-1701
Phone
(209) 478-1994
NPI assigned
May 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Authorized official

Name
Violeta T Gapasin
Title
Owner
Phone
(209) 478-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X LTC80072F CA Primary

Addresses

Primary practice location

2451 Shropshire Dr
Stockton, CA 95209-1701

Mailing address

PO Box 691581
Stockton, CA 95269-1581
Phone (209) 478-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 05G703

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
GAPASIN MANOR ICF DDN #1
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Sep 21, 1993
Last certification
Jan 29, 2025
Beds
6
Ownership / control type
Other (specify)
Facility address
2451 Shropshire Drive
Stockton, CA 95209

National Provider Directory

National Provider Directory
Tax ID family
Gapasin Manor Icfddn 13 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1568676492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 691581",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952691581",
            "telephone_number": "209-478-9400",
            "fax_number": "209-954-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2451 SHROPSHIRE DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952091701",
            "telephone_number": "209-478-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAPASIN MANOR ICFDDN #1",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "GAPASIN",
        "authorized_official_first_name": "VIOLETA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "209-478-9400"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "LTC80072F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.