Provider Demographics
NPI:1821082637
Name:KARMA INC
Entity Type:Organization
Organization Name:KARMA INC
Other - Org Name:MANTECA CARE AND REHAB. CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PREMA
Authorized Official - Middle Name:
Authorized Official - Last Name:THEKKEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-449-3400
Mailing Address - Street 1:410 EASTWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MANTECA
Mailing Address - State:CA
Mailing Address - Zip Code:95336-3167
Mailing Address - Country:US
Mailing Address - Phone:209-239-1222
Mailing Address - Fax:209-239-4919
Practice Address - Street 1:410 EASTWOOD AVE
Practice Address - Street 2:
Practice Address - City:MANTECA
Practice Address - State:CA
Practice Address - Zip Code:95336-3167
Practice Address - Country:US
Practice Address - Phone:209-239-1222
Practice Address - Fax:209-239-4919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-07
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA23-27028-3314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA23-27028-3OtherSTATE ID
CAZZR06216GMedicaid
CA23-27028-3OtherSTATE ID
CAZZR06216GMedicaid
CA056216Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER