Organization
SIGNATURE LIVING ON LAVELLI WAY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR ENERO (CEO)
(916) 812-0944
Entity
Organization
Contact information
Practice address
10125 LAVELLI WAY, ELK GROVE, CA 95757-4317
(916) 812-0944
Mailing address
4453 SOPHISTRY DR, RANCHO CORDOVA, CA 95742-8073
(916) 812-0944
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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