Organization
COUNTRY LIVIN' SENIOR HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAURA GENELLE WILLISON (OWNER/ADMINISTRATOR)
(805) 461-5306
Entity
Organization
Contact information
Practice address
4930 SYCAMORE RD, ATASCADERO, CA 93422-4314
(805) 461-5306
(805) 464-0652
Mailing address
4930 SYCAMORE RD, ATASCADERO, CA 93422-4314
(805) 461-5306
(805) 464-0652
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
CA
Other
Enumeration date
04/11/2008
Last updated
04/11/2008
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