# EAGLE VALLEY CARE CENTRE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093595142
- **Authorized official:** MS. AFRODESIA CUBETA LOPOZ ADMINISTRATOR (MANAGER)
- **Authorized official phone:** (925) 483-1096

## Contact information

- **Practice address:** 1807 E LONG ST, CARSON CITY, NV 89706-3214
- **Practice address phone:** (925) 483-1096
- **Practice address fax:** (925) 955-9000
- **Mailing address:** 1149 FAIR WEATHER CIR, CONCORD, CA 94518-1939
- **Mailing address phone:** (925) 483-1096
- **Mailing address fax:** (925) 955-9000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 10/04/2023
- **Last updated:** 10/04/2023