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General NPI Number Information
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NPI Number | 1528979002
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Entity Type | Organization
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Legal Business Name | SIGNATURE LIVING ON SHADY RIVER CIRCLE, LLC
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Dates
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Enumeration Date | 09/15/2026
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Last Update Date | 09/15/2026
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Provider Practice Location Address
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Address Line | 51 SHADY RIVER CIR
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City | SACRAMENTO
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State | CA
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Zip | 95831-3432
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Country | US
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Telephone | 916-812-0944
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Fax | 916-266-9391
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Provider Business Mailing Address
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Address Line | 4453 SOPHISTRY DR
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City | RANCHO CORDOVA
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State | CA
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Zip | 95742-8073
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Country | US
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Telephone | 916-812-0944
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Fax | 916-266-9391
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Authorized Official
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Title or Position | CEO
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Name | EDGAR ENERO
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Credential |
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Telephone | 916-812-0944
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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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