Organization
ELAN SENIOR LIVING DBA THE LIVING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT ALEN PAULY CAS (PROGRAM DIRECTOR)
(209) 892-3487
Entity
Organization
Contact information
Practice address
821 E ST, PATTERSON, CA 95363-2670
(209) 892-3487
(209) 892-1387
Mailing address
PO BOX 1626, 821 E ST., PATTERSON, CA 95363-1626
(209) 892-3487
(209) 892-1387
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
500013AP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004929
PROVIDER NUMBER
CA
Enumeration date
01/12/2007
Last updated
08/22/2020
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