Provider Demographics
NPI:1760253298
Name:LIMERIDGE SENIOR LIVING LLC
Entity Type:Organization
Organization Name:LIMERIDGE SENIOR LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:FIEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-768-4633
Mailing Address - Street 1:1100 FAIR WEATHER CIR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-1940
Mailing Address - Country:US
Mailing Address - Phone:925-798-8239
Mailing Address - Fax:
Practice Address - Street 1:1100 FAIR WEATHER CIR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-1940
Practice Address - Country:US
Practice Address - Phone:925-798-8239
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility