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BILLING_2022
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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EMPIRE
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1130
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1600 - Food Program
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PR0528477
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BILLING_2022
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Entry Properties
Last modified
9/26/2022 4:47:09 PM
Creation date
9/26/2022 4:37:02 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
FileName_PostFix
2022
RECORD_ID
PR0528477
PE
1628
FACILITY_ID
FA0019191
FACILITY_NAME
PRESTIGE SENIOR LIVING AT MANTECA
STREET_NUMBER
1130
STREET_NAME
EMPIRE
STREET_TYPE
AVE
City
MANTECA
Zip
95336
APN
20850044
CURRENT_STATUS
01
SITE_LOCATION
1130 EMPIRE AVE
P_LOCATION
04
P_DISTRICT
005
QC Status
Approved - Send Email
Scanner
Accounting
Supplemental fields
EmailAddr
AR0034155 mantecaom@prestigecare.com;
EmailSent
9/26/2022 4:47:07 PM
FilePath
D:\CAPTURE\EHD\Batch\Operating Permits
ParentPath
Operating Permits
PermitRecordID
PR0528477
Tags
EHD - Public
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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# PT0019814 for Record ID # PR0528477 <br /> Valid From 10/1/2022 To 9/30/2023 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: PRESTIGE CARE INC <br /> DBA: PRESTIGE SENIOR LIVING AT MICA <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: PRESTIGE SENIOR LIVING AT MANTECA Facility ID FA0019191 <br /> 1130 EMPIRE AVE Account ID AR0034155 <br /> MANTECA, CA 95336 Issued 9/26/2022 <br /> Billing Address: ATTN : TAYLOR MEAD <br /> PRESTIGE SENIOR LIVING AT MANTECA <br /> 1130 EMPIRE AVE <br /> MANTECA, CA 95336 <br /> combined.rpt End of report <br />
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