Provider Demographics
NPI:1477168656
Name:LINCOLN RETIREMENT VILLA
Entity Type:Organization
Organization Name:LINCOLN RETIREMENT VILLA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADONA
Authorized Official - Middle Name:S
Authorized Official - Last Name:NACAPUY-ESPERANZA
Authorized Official - Suffix:
Authorized Official - Credentials:RN, NP
Authorized Official - Phone:707-334-0749
Mailing Address - Street 1:111 TERRAZZO LN
Mailing Address - Street 2:
Mailing Address - City:AMERICAN CANYON
Mailing Address - State:CA
Mailing Address - Zip Code:94503-3169
Mailing Address - Country:US
Mailing Address - Phone:707-334-0749
Mailing Address - Fax:
Practice Address - Street 1:41040 LINCOLN ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-4316
Practice Address - Country:US
Practice Address - Phone:510-656-4373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-14
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility