=====================================================
General NPI Number Information
=====================================================
NPI Number | 1841246659
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CONSOLIDATED RESOURCES HEALTH CARE FUND I, L.P.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/25/2006
-----------------------------------------------------
Last Update Date | 01/07/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1045 S 308TH ST
-----------------------------------------------------
City | FEDERAL WAY
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98003-4706
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-946-2273
-----------------------------------------------------
Fax | 253-946-1596
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3001 KEITH ST NW
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | TN
-----------------------------------------------------
Zip | 37312-3713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 423-473-5751
-----------------------------------------------------
Fax | 423-993-8342
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSISTANT SECRETARY
-----------------------------------------------------
Name | CINDY S. CROSS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 423-473-5867
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 1107
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------