Provider Demographics
NPI:1376300145
Name:SEASONED ELITE ASSISTED LIVING
Entity type:Organization
Organization Name:SEASONED ELITE ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - ADMINISTRATOR - LICENSEE
Authorized Official - Prefix:
Authorized Official - First Name:ALISON
Authorized Official - Middle Name:
Authorized Official - Last Name:COOPER-EDISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-829-7836
Mailing Address - Street 1:13403 DALI AVE
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93314-6924
Mailing Address - Country:US
Mailing Address - Phone:661-829-7836
Mailing Address - Fax:661-215-5786
Practice Address - Street 1:13403 DALI AVE
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93314-6924
Practice Address - Country:US
Practice Address - Phone:661-829-7836
Practice Address - Fax:661-215-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility