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General NPI Number Information
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NPI Number | 1962388850
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Entity Type | Organization
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Legal Business Name | SE CLEARBROOK OPCO, LLC
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Dates
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Enumeration Date | 08/14/2025
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Last Update Date | 08/14/2025
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Provider Practice Location Address
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Address Line | 12295 SCHOLD RD NW
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City | SILVERDALE
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State | WA
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Zip | 98383-9506
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Country | US
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Telephone | 360-692-1228
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Fax |
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Provider Business Mailing Address
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Address Line | 6841 ELM ST PO BOX 258
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City | MCLEAN
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State | VA
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Zip | 22101-8009
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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 | AUTHORIZED OFFICIAL
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Name | STUART GILBERT
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Credential |
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Telephone | 305-527-3743
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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 |
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License Number State |
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