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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# PT0019099 for Record ID # PR0527300 <br /> Valid From 8/1/2023 To 7/31/2024 <br /> PERMITS TO OPERATE are NOT TRANSFERABLE <br /> and may be SUSPENDED or REVOKED for cause. <br /> PERMIT(s)Valid only for: LODI SKILLED NURSING SVC <br /> DBA: FAIRMONT REHABILITATION HOSPIT <br /> THIS FORM MUST BE DISPLAYED CONSPICUOUSLY ON THE PREMISES <br /> Regulated Facility: FAIRMONT REHABILITATION HOSPITAL Facility ID FA0009730 <br /> 950 S FAIRMONT AVE Account ID AR0016730 <br /> LODI, CA 95240 Issued 7/10/2023 <br /> Billing Address: ATTN : <br /> FAIRMONT REHABILITATION HOSPITAL <br /> 950 S FAIRMONT AVE <br /> LODI, CA 95240 <br /> 7024.rpt End of report <br />