| NPI | 1154948065 |
|---|---|
| Doing Business As | SULLIVAN PARK COTTAGES |
| Entity Type | Organization |
| Authorized Contact | GREGORY VISLOCKY Managing Member 360-735-7155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2020-06-26 |