Organization
ELAN SENIOR LIVING
Active
Other names
The Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLE DEANNE BLANCHARD (OFFICE MANAGER)
(209) 892-3487
Entity
Organization
Contact information
Practice address
1717 COFFEE RD, SUITE A, MODESTO, CA 95355-2808
(209) 577-6945
(209) 577-5674
Mailing address
1717 COFFEE RD, SUITE A, MODESTO, CA 95355-2808
(209) 577-6945
(209) 577-5674
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
500013 CP
CA
Other
Enumeration date
10/12/2007
Last updated
10/12/2007
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