# COVENANT LIVING WEST

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brandel Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184021768
- **Authorized official:** MRS. ELIZABETH A MALZAHN (NATIONAL DIRECTOR OF HEALTHCARE)
- **Authorized official phone:** (773) 878-4430

## Contact information

- **Practice address:** 1801 N OLIVE AVE, TURLOCK, CA 95382-2568
- **Practice address phone:** (209) 667-5600
- **Mailing address:** 5700 OLD ORCHARD RD, SUITE 100, SKOKIE, IL 60077-1036
- **Mailing address phone:** (773) 878-4430

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 055635 | CA | Yes |

## Other

- **Enumeration date:** 11/26/2014
- **Last updated:** 07/30/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1306281688 | NPI | CA |