Active NPI
Five Star Quality Care-Ca II LLC
- Skilled Nursing Facility
- Stockton, CA
National Provider Identifier
1679528988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- 030000054
- Legal business name
- FIVE STAR QUALITY CARE-CA II LLC
- Doing business as
- La Salette Health and Rehabilitation Center
- Practice address
- 537 E Fulton St
Stockton, CA 95204-2227 - Phone
- (209) 466-5945
- Fax
- (209) 466-5945
- NPI assigned
- May 24, 2006
- Organization subpart
- Yes
- Parent organization
- FIVE STAR QUALITY CARE-CA II LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Katherine E. Potter
- Title
- President & Chief Executive Officer
- Phone
- (617) 796-8387
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | 030000054 | CA | Primary |
Addresses
Primary practice location
537 E Fulton St
Stockton, CA 95204-2227
Mailing address
537 E Fulton St
Stockton, CA 95204-2227
Phone (209) 466-2066
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZR05833H | Medicaid | CA |
Other names 1
- La Salette Health and Rehabilitation Center
National Provider Directory
National Provider Directory- Part of
- Five Star Quality Care-Ca II LLC
Locations
537 E Fulton St
Stockton, CA 95204
Phone (209) 466-2066
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1553212800000",
"number": "1679528988",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "537 E FULTON ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952042227",
"telephone_number": "209-466-2066",
"fax_number": "209-466-5945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "537 E FULTON ST",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952042227",
"telephone_number": "209-466-5945",
"fax_number": "209-466-5945"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FIVE STAR QUALITY CARE-CA II LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FIVE STAR QUALITY CARE-CA II LLC",
"enumeration_date": "2006-05-24",
"last_updated": "2019-03-22",
"status": "A",
"authorized_official_last_name": "POTTER",
"authorized_official_first_name": "KATHERINE",
"authorized_official_middle_name": "E.",
"authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
"authorized_official_telephone_number": "617-796-8387"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "CA",
"license": "030000054",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "ZZR05833H",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "La Salette Health and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "La Salette Health and Rehabilitation Center",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.