Provider Demographics
NPI:1851730469
Name:LIVING SOLUTIONS II, LLC
Entity Type:Organization
Organization Name:LIVING SOLUTIONS II, LLC
Other - Org Name:CLOVER GARDENS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DON
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-812-6868
Mailing Address - Street 1:7104 SANTA JUANITA AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGEVALE
Mailing Address - State:CA
Mailing Address - Zip Code:95662-2832
Mailing Address - Country:US
Mailing Address - Phone:916-988-0157
Mailing Address - Fax:916-988-0884
Practice Address - Street 1:7104 SANTA JUANITA AVE
Practice Address - Street 2:
Practice Address - City:ORANGEVALE
Practice Address - State:CA
Practice Address - Zip Code:95662-2832
Practice Address - Country:US
Practice Address - Phone:916-988-0157
Practice Address - Fax:916-988-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA347004842310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility