Provider Demographics
NPI:1871282244
Name:LDS HOMES LLC
Entity type:Organization
Organization Name:LDS HOMES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SAYSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-565-7333
Mailing Address - Street 1:836 SAN SIMEON DR
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94518-2245
Mailing Address - Country:US
Mailing Address - Phone:619-565-7333
Mailing Address - Fax:925-483-2595
Practice Address - Street 1:836 SAN SIMEON DR
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94518-2245
Practice Address - Country:US
Practice Address - Phone:619-565-7333
Practice Address - Fax:925-483-2595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility