Organization · Type 2 NPI

Summerville at Fairwood Manor, LLC

Assisted Living Facility · Anaheim, CA

NPI number 1609106590 Active

Practice location

200 N Dale Ave
Anaheim, CA 92801-4897

Call (714) 761-5771 Map

Mailing address

3131 Elliott Ave Ste 500
Seattle, WA 98121-1032

Specialties and licenses

Taxonomy	Code	License
Assisted Living Facility Primary	310400000X	None listed

Assisted Living Facility: A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

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NPI record

NPI: 1609106590
Entity type: Organization (Type 2)
Issued: Dec 28, 2009
Last updated: Dec 28, 2009
Status: Active
Subpart: Yes of Summerville at Cobbco, Inc.

Other names

<unavail>
Emeritus at Fairwood Manor · doing business as

Authorized official

Noelle Bickel
Licensing Specialist
(206) 298-2909

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1609106590

Summerville at Fairwood Manor, LLC's National Provider Identifier is 1609106590, issued on Dec 28, 2009. The primary taxonomy on file is Assisted Living Facility (310400000X), and the practice location is in Anaheim, CA. The record was last updated on Dec 28, 2009.