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SAN JOAQU UNTY ME <br /> ENVIRONNTAL HEALT EPARTWNT <br /> R <br /> t <br /> 1868 E. Hazelton Ave. • Stockton,CA 95205-6232 • Phone(209) 468-3420 x <br /> x Donna Heran,R.E.H.S.,Director <br /> } ° ENVIRONMENTAL HEALTH <br /> g <br /> PERMIT TO OPERATE : 4524- SKILLED NURSING FACILITY <br /> K <br /> Permit ID# PT0000523 for Record ID# PR0450031 <br /> '& Valid From 1/1/2015 To 12/31/2015 <br /> 71 <br /> R M � — <br /> � a <br /> r <br /> � A <br /> r S s <br /> �r <br /> t <br /> ih t <br /> gP <br /> 1 <br /> F 2 <br /> y1% t .. <br /> 14V'i <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br />+ _ PERMIT(s) Valid only for: VIENNA CONVALESCENT HOSPITAL <br /> r E <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Facility ID FA0000517 <br /> Regulated Facility: VIENNA CONVALESCENT HOSPITAL Account ID AR0000.516 <br /> 800 S HAM LN <br /> Issued 11/21/2014 <br /> LODI CA 95242 <br /> "A <br /> Billing Address: VIENNA CONVALESCENT HOSPITAL <br /> 800 S HAM LANE <br /> LODI CA 95242 <br /> FK <br />