| NPI | 1740274695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KYLLE FISH Administrator 509-248-4173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: WA NH1291) |
| Enumeration Date | 2005-09-07 |
| Last Update Date | 2020-08-22 |