Organization
EAGLE LAKE VILLAGE
Active
Organization
EAGLE LAKE VILLAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK J CIMINO (CEO)
(916) 704-6275
Entity
Organization
Contact information
Practice address
2001 PAUL BUNYAN RD., SUSANVILLE, CA 96130
(530) 457-4380
Mailing address
2001 PAUL BUNYAN RD., SUSANVILLE, CA 96130
(530) 457-4380
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
11/17/2022
Last updated
11/17/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up