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General NPI Number Information
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NPI Number | 1841008448
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Entity Type | Organization
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Legal Business Name | FRASCO & SARAUSAD BEVERLY LANE INC
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Dates
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Enumeration Date | 12/28/2024
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Last Update Date | 12/28/2024
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Provider Practice Location Address
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Address Line | 5910 BEVERLY LN
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City | EVERETT
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State | WA
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Zip | 98203-3433
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Country | US
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Telephone | 425-374-7943
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Fax | 425-512-8941
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Provider Business Mailing Address
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Address Line | 931 12TH AVE N
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City | EDMONDS
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State | WA
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Zip | 98020-2936
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Country | US
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Telephone | 425-435-6594
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Fax | 206-238-9350
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Authorized Official
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Title or Position | EMPLOYEE
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Name | MR. CESAR FRASCO SARAUSAD II
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Credential |
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Telephone | 425-435-6594
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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