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General NPI Number Information
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NPI Number | 1649951328
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Entity Type | Organization
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Legal Business Name | AGEMARK MANAGEMENT. LLC
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Dates
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Enumeration Date | 07/26/2023
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Last Update Date | 07/26/2023
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Provider Practice Location Address
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Address Line | TREVISTA CONCORD 1081 MOHR LANE
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City | CONCORD
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State | CA
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Zip | 94518
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Country | US
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Telephone | 925-798-3900
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Fax |
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Provider Business Mailing Address
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Address Line | AGEMARK MANAGEMENT, LLC 25 AVENIDA DE ORINDA
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City | ORINDA
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State | CA
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Zip | 94563
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Country | US
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Telephone | 510-548-6600
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARTIN (MARTY) L HUG
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Credential |
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Telephone | 402-469-0750
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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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