Healthcare Provider Details

I. General information

NPI: 1447176490
Provider Name (Legal Business Name): A SUITELIFE FOR ELDERS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2069 GILL PORT LN
WALNUT CREEK CA
94598-1151
US

IV. Provider business mailing address

2069 GILL PORT LN
WALNUT CREEK CA
94598-1151
US

V. Phone/Fax

Practice location:
  • Phone: 925-895-4507
  • Fax: 925-943-3004
Mailing address:
  • Phone: 925-895-4507
  • Fax: 925-943-3004

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: MS. ROGUE MARYDITH CASTRO
Title or Position: CEO
Credential:
Phone: 925-895-4507