Healthcare Provider Details

I. General information

NPI: 1801694187
Provider Name (Legal Business Name): LLC RETIREMENT HOMES II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2025
Last Update Date: 03/19/2025
Certification Date: 03/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1944 FAXON DRIVE
ATWATER CA
95301
US

IV. Provider business mailing address

1944 FAXON DRIVE
ATWATER CA
95301
US

V. Phone/Fax

Practice location:
  • Phone: 209-357-9525
  • Fax:
Mailing address:
  • Phone: 209-357-9525
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: LINDSEY LAMERSON
Title or Position: CEO/LICENSEE
Credential:
Phone: 209-357-9525