Organization
ELAN SENIOR LIVING DBA THE LIVING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JENNIFER ARLENE TAYLOR CAS (PROGRAM DIRECTOR)
(209) 575-2013
Entity
Organization
Contact information
Practice address
416 CORSON AVE, MODESTO, CA 95350-5408
(209) 575-2013
(209) 575-2017
Mailing address
416 CORSON AVE, MODESTO, CA 95350-5408
(209) 575-2013
(209) 575-2017
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
500013EP
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004929
PROVIDER NUMBER
CA
Enumeration date
01/15/2007
Last updated
08/22/2020
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