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General NPI Number Information
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NPI Number | 1437076411
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Entity Type | Organization
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Legal Business Name | J&J ASSISTED LIVING, LLC
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Dates
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Enumeration Date | 07/01/2026
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Last Update Date | 07/01/2026
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Provider Practice Location Address
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Address Line | 1217 LANCE DR
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City | SANTA ROSA
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State | CA
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Zip | 95401-4550
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Country | US
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Telephone | 707-548-8176
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Fax | 707-575-1717
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Provider Business Mailing Address
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Address Line | 3615 CHANATE RD
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City | SANTA ROSA
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State | CA
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Zip | 95404-1804
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Country | US
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Telephone | 707-548-8176
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Fax | 707-575-1717
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Authorized Official
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Title or Position | MANAGER
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Name | JOSEPHINE CREDO ALCONES
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Credential |
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Telephone | 707-548-8176
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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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