NPIMap

Organization Active NPI

Ever Well Health Systems, LLC

Doing business as Delta at The Portside

  • Mental Illness Community Based Residential Treatment Facility
  • Stockton, CA
National Provider Identifier
1851831465
Registry record updated Mar 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X
Legal business name
EVER WELL HEALTH SYSTEMS, LLC
Doing business as
Delta at The Portside
Practice address
1950 E Sonora St
Stockton, CA 95205-6364
Phone
(805) 242-0135
NPI assigned
Mar 1, 2017
Last updated
Mar 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2017

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

Authorized official

Name
Richard Stuart Groberg
Title
Cfo
Phone
(805) 070-0989

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Illness Community Based Residential Treatment Facility 320800000X NU Primary

Addresses

Primary practice location

1950 E Sonora St
Stockton, CA 95205-6364

Mailing address

391 Front St
Suite E
Grover Beach, CA 93433-1553
Phone (802) 242-0135

Other names 1

  • Delta at The Portside Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Delta at the Gold Country I4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

1950 E Sonora St
Stockton, CA 95205
Phone (209) 943-3511

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488326400000",
    "number": "1851831465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 FRONT ST",
            "address_2": "SUITE E",
            "city": "GROVER BEACH",
            "state": "CA",
            "postal_code": "934331553",
            "telephone_number": "802-242-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1950 E SONORA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952056364",
            "telephone_number": "805-242-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVER WELL HEALTH SYSTEMS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-01",
        "last_updated": "2017-03-01",
        "status": "A",
        "authorized_official_last_name": "GROBERG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "STUART",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "805-070-0989"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Delta at The Portside",
            "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 1, 2017; 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.