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General NPI Number Information
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NPI Number | 1023219789
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Entity Type | Organization
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Legal Business Name | WESTERN LIVING CONCEPTS
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2740 TIMBER RIDGE LN
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City | EUREKA
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State | CA
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Zip | 95503-4883
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Country | US
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Telephone | 707-443-3000
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Fax | 707-443-3027
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Provider Business Mailing Address
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Address Line | 2740 TIMBER RIDGE LN
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City | EUREKA
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State | CA
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Zip | 95503-4883
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Country | US
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Telephone | 707-443-3000
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Fax | 707-443-3027
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Authorized Official
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Title or Position | COO
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Name | MRS. LARONA KAY FARNUM
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Credential |
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Telephone | 707-443-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | CA
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