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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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