Organization
SUMMERVILLE AT HERITAGE PLACE, LLC
Active
Organization
SUMMERVILLE AT HERITAGE PLACE, LLC
Active
Other names
Emeritus at Heritage Place
Organization subpart
No
Provider details
NPI number
Authorized official
NOELLE DIAZ (LICENSING SPECIALIST)
(206) 301-4060
Entity
Organization
Contact information
Practice address
355 W GRANT LINE RD, TRACY, CA 95376-2500
(209) 835-1000
Mailing address
3000 EXECUTIVE PKWY, SUITE 530, SAN RAMON, CA 94583-4255
(925) 866-1999
(925) 866-8468
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
397003261
CA
311500000X
Alzheimer Center (Dementia Center)
397003261
CA
Other
Enumeration date
06/05/2007
Last updated
09/10/2009
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