Delta Skilled Nursing Center, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

030000138 Issued in CA

Legal business name

DELTA SKILLED NURSING CENTER, INC.

Doing business as

Delta Rehabilitation & Care Center

Practice address

1334 S Ham LN
Lodi, CA 95242-3903

Phone

(209) 334-3825

Fax

(209) 368-7714

NPI assigned

Aug 3, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Terry Bane

Title

President

Phone

(530) 897-5100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Delta Rehabilitation & Care Center Doing business as

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1851392500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1334 S HAM LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423903",
            "telephone_number": "209-334-3825",
            "fax_number": "209-368-7714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1334 S HAM LN",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952423903",
            "telephone_number": "209-334-3825",
            "fax_number": "209-368-7714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DELTA SKILLED NURSING CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-03",
        "last_updated": "2013-11-20",
        "status": "A",
        "authorized_official_last_name": "BANE",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "530-897-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "030000138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR18503H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta Rehabilitation & Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Lodi, CA
• Providers in Lodi, 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 Nov 20, 2013; 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.