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Organization

NOV PERSHING LLC

Active
Parent organization
NOVELLUS LIVING GROUP LLC
Other names
CAMLU ASSISTED LIVING
Organization subpart
Yes

Provider details

NPI number
Legal business name
NOVELLUS LIVING GROUP LLC
Authorized official
CHRISTOPHER COULTER (PRINCIPAL)
(916) 759-1969
Entity
Organization

Contact information

Practice address
6037 N PERSHING AVE, STOCKTON, CA 95207-4158
(209) 951-2030
(209) 951-3036
Mailing address
7405 GREENBACK LN # 336, CITRUS HEIGHTS, CA 95610-5653

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Enumeration date
06/30/2021
Last updated
06/30/2021
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