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General NPI Number Information
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NPI Number | 1841172798
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Entity Type | Organization
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Legal Business Name | WOODLAND GARDENS SENIOR LIVING LLC
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 240 PALM AVE
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City | WOODLAND
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State | CA
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Zip | 95695-2844
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Country | US
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Telephone | 530-661-0574
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Fax |
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Provider Business Mailing Address
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Address Line | 7920 ALTA SUNRISE DR STE 250
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City | CITRUS HEIGHTS
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State | CA
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Zip | 95610-7963
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Country | US
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Telephone | 916-486-9639
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARK J CIMINO SR.
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Credential |
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Telephone | 916-704-6275
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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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