Organization
LAKE SHASTA, LLC
Active
Organization
LAKE SHASTA, LLC
Active
Other names
Delta Shores Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN WILLIAMS (MANAGING MEMBER)
(916) 299-7030
Entity
Organization
Contact information
Practice address
825 E 18TH ST, ANTIOCH, CA 94509-2835
(925) 706-7944
Mailing address
599 MENLO DR, ROCKLIN, CA 95765-3725
(916) 299-7030
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
12/12/2024
Last updated
12/12/2024
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