Healthcare Provider Details

I. General information

NPI: 1013441377
Provider Name (Legal Business Name): ASSISTED LIVING ALTERNATIVES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2017
Last Update Date: 04/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

708 27TH AVE
MILTON WA
98354-9300
US

IV. Provider business mailing address

708 27TH AVE
MILTON WA
98354-9300
US

V. Phone/Fax

Practice location:
  • Phone: 253-952-2052
  • Fax:
Mailing address:
  • Phone: 253-952-2052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number678600
License Number StateWA

VIII. Authorized Official

Name: JACQUELINE SARAH ANNE BEECH
Title or Position: PROVIDER/OWNER
Credential: NAR
Phone: 253-632-9434