LSREF GOLDEN OPS 26 (WA), LLC
Alzheimer Center
Port Orchard, Washington
Provider NPI: 1568699197
Organization Information:Organization Name: LSREF GOLDEN OPS 26 (WA), LLC
Practice Location:
300 S KITSAP BLVD PORT ORCHARD, WA 98366 US
Tel: 360-874-7400 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
300 S KITSAP BLVD PORT ORCHARD, WA 98366 US
Tel: 360-874-7400 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311500000X | Nursing & Custodial Care Facilities Alzheimer Center (Dementia Center) |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
315196 | WA | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin