Organization
THE ELDERLY INN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM TOPLEAN (OWNER)
(916) 806-2223
Entity
Organization
Contact information
Practice address
4824 LIVOTI AVE, FAIR OAKS, CA 95628-5008
(916) 806-2223
(916) 967-3099
Mailing address
4831 LIVOTI AVE, FAIR OAKS, CA 95628-5007
(916) 806-2223
(916) 967-3099
Taxonomy
Speciality
Code
Description
License number
State
311Z00000X
Custodial Care Facility
347001289
CA
311Z00000X
Custodial Care Facility
Primary
347003747
CA
311Z00000X
Custodial Care Facility
347003754
CA
311Z00000X
Custodial Care Facility
347004184
CA
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
About Stedi
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