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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1868 E.Hazelton Ave•Stockton,CA 95205-6232•Phone(209)468-3420 <br /> Jasjit Kang,R.E.H.S.,Director <br /> ENVIRONMENTAL HEALTH <br /> PERMIT TO OPERATE - PE 1628-LICENSED HEALTH CARE FACILITY <br /> Permit ID# PT0019094 for Record ID # PR0527295 <br /> Valid From 8/1/2022 To 7/31/2023 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: CRESTWOOD MANOR <br /> DBA: <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: CRESTWOOD MANOR Facility ID FA0018488 <br /> 1130 MONACO CT Account ID AR0032686 <br /> STOCKTON, CA 95207 Issued 6/29/2022 <br /> Billing Address: ATTN : <br /> CRESTWOOD MANOR <br /> 1130 MONACO CT <br /> STOCKTON, CA 95207 <br /> combined.rpt End of report <br />