Provider Demographics
NPI:1023219789
Name:WESTERN LIVING CONCEPTS
Entity type:Organization
Organization Name:WESTERN LIVING CONCEPTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MRS
Authorized Official - First Name:LARONA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:FARNUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-443-3000
Mailing Address - Street 1:2740 TIMBER RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:CA
Mailing Address - Zip Code:95503-4883
Mailing Address - Country:US
Mailing Address - Phone:707-443-3000
Mailing Address - Fax:707-443-3027
Practice Address - Street 1:2740 TIMBER RIDGE LN
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:CA
Practice Address - Zip Code:95503-4883
Practice Address - Country:US
Practice Address - Phone:707-443-3000
Practice Address - Fax:707-443-3027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility