Signature Living on Lavelli Way, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

SIGNATURE LIVING ON LAVELLI WAY, LLC

Practice address

10125 Lavelli Way
Elk Grove, CA 95757-4317

Phone

(916) 812-0944

NPI assigned

Apr 16, 2024

Last updated

Apr 16, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Edgar Enero

Title

Ceo

Phone

(916) 812-0944

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1952155954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4453 SOPHISTRY DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "957428073",
            "telephone_number": "916-812-0944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10125 LAVELLI WAY",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957574317",
            "telephone_number": "916-812-0944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIGNATURE LIVING ON LAVELLI WAY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-16",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A",
        "authorized_official_last_name": "ENERO",
        "authorized_official_first_name": "EDGAR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-812-0944"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachari Shubin
• Olena Shuprudko, COTA/L
• Sidiqa Sidiqi
• Jonathan Siegfried
• Sydnee Sifuentes
• Monalisa Silapan
• Marisol Silva Arias
• Savannah Lauren Silva McBride
• Daniella Silva-Perez
• Karina Silva

• Assisted Living Facility in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Assisted Living Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.