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General NPI Number Information
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NPI Number | 1225475858
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Entity Type | Organization
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Legal Business Name | BREMERTON HOUSING AUTHORITY
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Dates
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Enumeration Date | 05/22/2013
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 191 RUSSELL RD
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City | BREMERTON
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State | WA
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Zip | 98312-3415
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Country | US
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Telephone | 360-377-8300
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Fax | 360-377-6090
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Provider Business Mailing Address
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Address Line | PO BOX 2189
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City | BREMERTON
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State | WA
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Zip | 98310-0294
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | KURT WIEST
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Credential |
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Telephone | 360-616-7241
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 1983
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License Number State | WA
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