DEER TAIL SENIOR LVING, INC.
NPI 1013739663
Assisted Living Facility in Modesto, CA

Q: What is Deer Tail Senior Lving, Inc.'s NPI number?

The NPI number for Deer Tail Senior Lving, Inc. is 1013739663. It was assigned to this organization in the NPPES registry on October 25, 2024. The provider is doing business as Vintage Faire Residential.

Q: What is Deer Tail Senior Lving, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since October 25, 2024

3620 DALE RD STE A, MODESTO, CA 95356(209) 524-1798 Get Directions Write a Review

NPPES record last updated: January 30, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Deer Tail Senior Lving, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DEER TAIL SENIOR LVING, INC. (NPI 1013739663), doing business as Vintage Faire Residential, is a healthcare organization registered as an assisted living facility in Modesto, California and active in the NPI registry since October 2024. The organization lists Soon Burnam, Secretary, as its authorized official.

NPPES Registry Identity

NPI1013739663

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NameDEER TAIL SENIOR LVING, INC.

Location Address3620 DALE RD STE AModesto, CA 95356-0598

Mailing Address3620 Dale Rd Ste AModesto, CA 95356-0598

Phone(209) 524-1798

Organization SubpartNo

Authorized OfficialSoon BurnamSecretary · (949) 540-1249

Enumeration DateOctober 25, 2024

Last NPPES UpdateJanuary 30, 2025

NPPES CertifiedJanuary 30, 2025

✔ NPI 1013739663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

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.

3620 DALE RD STE A, Modesto, CA 95356

Open in Google Maps ↗

Other Names 1

Doing Business AsVintage Faire Residential

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

COVENANT CARE CALIFORNIA, LLC

Assisted Living Facility

3620 DALE RD STE A
MODESTO, CA 95356

Stanislaus County (209) 521-1798

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Deer Tail Senior Lving, Inc.'s NPI number?

The NPI number for Deer Tail Senior Lving, Inc. is 1013739663. It was assigned to this organization in the NPPES registry on October 25, 2024. The provider is doing business as Vintage Faire Residential.

Where is Deer Tail Senior Lving, Inc. located?

Deer Tail Senior Lving, Inc. is located at 3620 Dale Rd Ste A, Modesto, CA 95356. The listed phone number is (209) 524-1798.

What is Deer Tail Senior Lving, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Deer Tail Senior Lving, Inc. was last updated on January 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.