Healthcare Provider Details

I. General information

NPI: 1366617193
Provider Name (Legal Business Name): MULTICARE ADULT DAY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 04/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6442 YAKIMA AVE
TACOMA WA
98408-4599
US

IV. Provider business mailing address

PO BOX 5200
TACOMA WA
98415-0200
US

V. Phone/Fax

Practice location:
  • Phone: 253-459-7222
  • Fax:
Mailing address:
  • Phone: 253-459-7222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID J LARSON
Title or Position: DIRECTOR OF HOME AND COMMUNITY SVCS
Credential:
Phone: 253-459-8330