Marcies Manor Iii Icf

LBN: Marcies Manor Iii Icf
Marcies Manor Iii Icf is an health care organization with primary practice located at 1528 Venetian Dr , Stockton CA 95207-5422. The organization recently has only one registered license in Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, which is considered as the primary health care specialty. Marcies Manor Iii Icf can be contacted via phone (209) 952-6122, or through Patubo, Marcie H. via phone (209) 478-3391.

Contact Information

Primary practice address
1528 Venetian Dr Stockton CA 95207-5422
Phone: (209) 952-6122
Fax: (209) 478-3391
Website:
Map and Directions
Authorized official contact:
Name: Patubo, Marcie H.
Phone: (209) 478-3391

Health care specialties

SpecialtyCodeLicense #State
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X 100000773 California

Profile Details

NPI number 1932247541
LBN Legal business name Marcies Manor Iii Icf
DBA Doing business as
Authorized official Patubo, Marcie H.
Entity Organization
Organization subpart 1 No
Enumeration date Feb 3rd, 2007
Last updated Apr 30th, 2008 - about 17 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932247541 NPPES
California MEDICAID LTC61051F

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