Provider Demographics
NPI:1407997281
Name:AL DEL MONTE INC
Entity Type:Organization
Organization Name:AL DEL MONTE INC
Other - Org Name:STACIES CHALET
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SANDEEP
Authorized Official - Middle Name:
Authorized Official - Last Name:SAINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:831-375-2206
Mailing Address - Street 1:517 E FULTON AVE
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-2251
Mailing Address - Country:US
Mailing Address - Phone:925-222-0430
Mailing Address - Fax:831-375-3775
Practice Address - Street 1:517 E FULTON AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-2251
Practice Address - Country:US
Practice Address - Phone:209-910-5910
Practice Address - Fax:831-375-3775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347001977310400000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARCF00012FMedicaid