Healthcare Provider Details

I. General information

NPI: 1891148979
Provider Name (Legal Business Name): CARE CENTER NAMPA INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2016
Last Update Date: 07/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1127 CALDWELL BLVD
NAMPA ID
83651-1701
US

IV. Provider business mailing address

7700 NE PARKWAY DR SUITE 300
VANCOUVER WA
98662-6648
US

V. Phone/Fax

Practice location:
  • Phone: 208-465-4935
  • Fax:
Mailing address:
  • Phone: 360-816-8283
  • Fax: 360-816-8258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: GREGORY VISLOCKY
Title or Position: EX VP OF FINANCE / PARTNER
Credential:
Phone: 360-735-7155