Organization
DEER TAIL SENIOR LVING, INC.
Active
Other names
Vintage Faire Residential
Organization subpart
No
Provider details
NPI number
Authorized official
SOON BURNAM (SECRETARY)
(949) 540-1249
Entity
Organization
Contact information
Practice address
3620 DALE RD STE A, MODESTO, CA 95356-0598
(209) 524-1798
Mailing address
3620 DALE RD STE A, MODESTO, CA 95356-0598
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/25/2024
Last updated
01/30/2025
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