Organization
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Organization subpart
No
Provider details
NPI number
Authorized official
LILIBETH MEZA (OWNER/ADMINISTRATOR)
(916) 661-2940
Entity
Organization
Contact information
Practice address
8781 KELSEY DR, ELK GROVE, CA 95624-1872
(916) 661-2940
Mailing address
8781 KELSEY DR, ELK GROVE, CA 95624-1872
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
10/08/2020
Last updated
02/07/2023
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