Weldwoods Residential Care Home LLC

Primary specialty

Nursing Care AgencyTaxonomy code 251J00000X

Legal business name

WELDWOODS RESIDENTIAL CARE HOME LLC

Doing business as

Weldwoods

Practice address

1490 Pelusa LN
Manteca, CA 95337-8792

Phone

(510) 470-2881

NPI assigned

Feb 26, 2020

Organization subpart

No

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

Authorized official

Name

Mr. Bokime Etim

Title

Administrator/Managing Member

Phone

(510) 470-2881

Specialties & licenses 1

Addresses

Other names 1

• Weldwoods Doing business as

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

{
    "created_epoch": "1582675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582675200000",
    "number": "1811521073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 WELDWOOD CT APT 4",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321350",
            "telephone_number": "510-470-2881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 PELUSA LN",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953378792",
            "telephone_number": "510-470-2881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELDWOODS RESIDENTIAL CARE HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-26",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A",
        "authorized_official_last_name": "ETIM",
        "authorized_official_first_name": "BOKIME",
        "authorized_official_title_or_position": "ADMINISTRATOR/MANAGING MEMBER",
        "authorized_official_telephone_number": "510-470-2881",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weldwoods",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephani Rae Walton, RN, BSN, MS, CDE
• Qihua Wang
• Annie Gene Banks Wardle, MSW
• Dave B Watts, RPH
• Jerry W Weiner, MD
• Maycie Eliana Werner
• Douglas Bryan Wesson, ACA
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• West Coast Medical Labs Inc
• Western Dental Services, Inc.

• Nursing Care Agency in Manteca, CA
• Providers in Manteca, CA by specialty
• Nursing Care Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.