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General NPI Number Information
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NPI Number | 1376300145
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Entity Type | Organization
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Legal Business Name | SEASONED ELITE ASSISTED LIVING
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 13403 DALI AVE
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City | BAKERSFIELD
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State | CA
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Zip | 93314-6924
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Country | US
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Telephone | 661-829-7836
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Fax | 661-215-5786
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Provider Business Mailing Address
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Address Line | 13403 DALI AVE
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City | BAKERSFIELD
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State | CA
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Zip | 93314-6924
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Country | US
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Telephone | 661-829-7836
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Fax | 661-215-5786
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Authorized Official
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Title or Position | OWNER - ADMINISTRATOR - LICENSEE
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Name | ALISON COOPER-EDISON
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Credential |
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Telephone | 661-829-7836
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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 |
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