Healthcare Provider Details

I. General information

NPI: 1568684041
Provider Name (Legal Business Name): ESC III LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 02/24/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1831 MURCHISON
EL PASO TX
79902
US

IV. Provider business mailing address

3131 ELLIOTT AVE STE 500
SEATTLE WA
98121-1032
US

V. Phone/Fax

Practice location:
  • Phone: 915-533-8271
  • Fax: 915-533-1307
Mailing address:
  • Phone: 206-298-2909
  • Fax: 206-301-4500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number911781748
License Number StateTX

VIII. Authorized Official

Name: NOELLE DIAZ BICKEL
Title or Position: LICENSING SPECIALIST
Credential:
Phone: 206-298-2909