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General NPI Number Information
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NPI Number | 1770520249
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Entity Type | Organization
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Legal Business Name | RENTON CARE CENTER, INC
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 11/16/2012
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Provider Practice Location Address
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Address Line | 80 SW 2ND ST
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City | RENTON
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State | WA
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Zip | 98055-1937
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Country | US
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Telephone | 425-226-4610
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Fax | 425-255-6561
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Provider Business Mailing Address
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Address Line | 80 SW 2ND ST
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City | RENTON
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State | WA
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Zip | 98055-1937
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Country | US
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Telephone | 425-226-4610
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Fax | 425-255-6561
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Authorized Official
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Title or Position | EX VP OF FINANCE / PARTNER
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Name | GREGORY J VISLOCKY
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Credential |
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Telephone | 360-735-7155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 1378
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 1378
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License Number State | WA
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