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Organization
COVENANT LIVING WEST
Active
Organization
COVENANT LIVING WEST
Active
Other names
Brandel Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ELIZABETH A MALZAHN (NATIONAL DIRECTOR OF HEALTHCARE)
(773) 878-4430
Entity
Organization
Contact information
Practice address
1801 N OLIVE AVE, TURLOCK, CA 95382-2568
(209) 667-5600
Mailing address
5700 OLD ORCHARD RD, SUITE 100, SKOKIE, IL 60077-1036
(773) 878-4430
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
055635
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1306281688
NPI
CA
Enumeration date
11/26/2014
Last updated
07/30/2019
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