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General NPI Number Information
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NPI Number | 1891817342
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Entity Type | Organization
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Legal Business Name | ELISEO
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 1301 N HIGHLANDS PKWY
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City | TACOMA
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State | WA
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Zip | 98406-2116
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Country | US
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Telephone | 253-752-7112
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Fax | 253-752-7265
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Provider Business Mailing Address
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Address Line | 1301 N HIGHLANDS PKWY
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City | TACOMA
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State | WA
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Zip | 98406-2116
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Country | US
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Telephone | 253-752-7112
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Fax | 253-752-7265
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Authorized Official
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Title or Position | VICE PRESIDENT OF FINANCE
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Name | MR. DAVID HOFFMAN
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Credential |
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Telephone | 253-756-7565
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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 | BH1187
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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 | NH601
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License Number State | WA
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