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Organization

COVENANT CARE CALIFORNIA, LLC

Active
Other names
Vintage Faire Residential
Organization subpart
No

Provider details

NPI number
Authorized official
CAROL SPARKS (DIRECTOR OF REIMBURSEMENT)
(949) 349-1200
Entity
Organization

Contact information

Practice address
3620 DALE RD STE A, MODESTO, CA 95356-0598
(209) 521-1798
Mailing address
120 VANTIS DR STE 200, ALISO VIEJO, CA 92656-2677
(949) 349-1200

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
507000307
DEPARTMENT OF SOCIAL SERVICES
CA
Enumeration date
03/16/2022
Last updated
03/16/2022
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