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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E. Hazelton Ave. • Stockton, CA 95205-6232 • Phone (209) 46&3420 <br /> Donna Heran,R.E.H.S., Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - 1628 LICENSED HEALTH CARE FACILITY <br /> Permit ID# PT0019100 for Record ID# PR0527301 <br /> Valid From 8/1/2012 To 7/31/2013 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE- <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: GOOD SAMARITAN REHAB & CARE <br /> DBA: <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: GOOD SAMARITAN REHAB & CARE Facility ID FA0018492 <br /> 1630 N EDISON ST Account ID AR0032690 <br /> STOCKTON, CA 95204 Issued 7/2/2012 <br /> Billing Address: <br /> GOOD SAMARITAN REHAB & CARE <br /> 1630 N EDISON ST <br /> STOCKTON, CA. 95204 <br /> 7024.rp1 <br />