Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Eagle Lake Village

Organization Assisted Living Facility · NPI 1114636230

Eagle Lake Village is an Assisted Living Facility in Susanville, California. Registered with an NPI since 2022.

In the registry since
2022

Practice location Address checks out

2001 Paul Bunyan Rd
Susanville, CA 96130
Phone: (530) 457-4380
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1114636230
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mark Cimino — Ceo · (916) 704-6275
NPI enumeratedNovember 17, 2022
Last updated in NPPESNovember 17, 2022
Certification dateNovember 17, 2022
Mailing address2001 Paul Bunyan Rd., Susanville, CA 96130

Other providers in Susanville