Provider Demographics
NPI:1962440644
Name:ST. JOHN'S HEALTH CARE CENTER, INC.
Entity Type:Organization
Organization Name:ST. JOHN'S HEALTH CARE CENTER, INC.
Other - Org Name:ST. JOHN'S HOME HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EDNA
Authorized Official - Middle Name:PADILLA
Authorized Official - Last Name:NICOLAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-323-8145
Mailing Address - Street 1:4800 STOCKDALE HWY
Mailing Address - Street 2:SUITE 209
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-2636
Mailing Address - Country:US
Mailing Address - Phone:661-323-8145
Mailing Address - Fax:661-323-8146
Practice Address - Street 1:4800 STOCKDALE HWY
Practice Address - Street 2:SUITE 209
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-2636
Practice Address - Country:US
Practice Address - Phone:661-323-8145
Practice Address - Fax:661-323-8146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health