Gapasin Manor Icfddn #3

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

LTC80219F Issued in CA

Legal business name

GAPASIN MANOR ICFDDN #3

Practice address

3813 Steedman Way
Stockton, CA 95209-5020

Phone

(209) 952-6135

NPI assigned

May 10, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Violeta T. Gapasin

Title

Owner

Phone

(209) 478-9400

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 55G136

Legal name

GAPASIN MANOR ICF DDN #3

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Oct 2, 1997

Last certification

Aug 6, 2024

Beds

6

Ownership / control type

Private (proprietary)

Facility address

3813 Steedman Way
Stockton, CA 95209

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.

• Gapasin Manor Icfddn #1

  • Intellectual Disabilities Intermediate Care Facility
  • Stockton, CA
  • NPI 1568676492
  NPD tax ID
• Gapasin Manor Icfddn #2

  • Intellectual Disabilities Intermediate Care Facility
  • Stockton, CA
  • NPI 1194939025
  NPD tax ID

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": "1912111840",
    "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": "3813 STEEDMAN WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952095020",
            "telephone_number": "209-952-6135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAPASIN MANOR ICFDDN #3",
        "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",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "CA",
            "license": "LTC80219F",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Gannon, MD
• Alanna Gantan
• Tanisha J Ganub
• Gapasin Manor Icfddn #1
• Gapasin Manor Icfddn #2
• Gapuz Incorporated
• Shayla Gapuz
• Alvaro R Garay, PA-C
• Peter Garbeff, MD
• Jazmin Garces

• Intellectual Disabilities Intermediate Care Facility in Stockton, CA
• Providers in Stockton, CA by specialty
• Intellectual Disabilities Intermediate Care Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.