St Michael Convalescent Hospital Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

760077117 Issued in CA

Legal business name

ST MICHAEL CONVALESCENT HOSPITAL INC

Doing business as

Vintage Estates of Hayward

Practice address

25919 Gading Rd
Hayward, CA 94544-2725

Phone

(510) 782-3825

Fax

(510) 782-8793

NPI assigned

Oct 18, 2005

Organization subpart

Yes

Parent organization

SR ADMINISTRATIVE SERVICES, INC.As reported in NPPES

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

Authorized official

Name

Mrs. Sally Jane Rapp

Title

Director

Phone

(510) 782-3825

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vintage Estates of Hayward Doing business as

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1912996349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25919 GADING RD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945442725",
            "telephone_number": "510-782-3825",
            "fax_number": "510-782-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25919 GADING RD",
            "city": "HAYWARD",
            "state": "CA",
            "postal_code": "945442725",
            "telephone_number": "510-782-3825",
            "fax_number": "510-782-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MICHAEL CONVALESCENT HOSPITAL INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SR ADMINISTRATIVE SERVICES, INC.",
        "enumeration_date": "2005-10-18",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "RAPP",
        "authorized_official_first_name": "SALLY",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "510-782-3825",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "760077117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZZR05359G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vintage Estates of Hayward",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Morgan Rene Stack, RN

• Skilled Nursing Facility in Hayward, CA
• Providers in Hayward, 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 Jan 13, 2010; 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.