MEDICARE: HIGHLINE CARE CENTERS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	1306	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386639433
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HIGHLINE CARE CENTERS, LLC

Provider Business Mailing Address
First Line	:	625 OKANOGAN AVE
Second Line	:
City	:	WENATCHEE
State	:	WA
Zip	:	98801-6409
Country	:	US
Telephone Number	:	509-662-1636
Fax Number	:	509-662-8690

Provider Business Practice Location Address
First Line	:	609 HIGHLINE DR
Second Line	:
City	:	EAST WENATCHEE
State	:	WA
Zip	:	98802-5603
Country	:	US
Telephone Number	:	509-662-1636
Fax Number	:	509-662-8690

Authorized Official
Title or Position	:	CONTROLLER
Name	:	MS. DIANA V WILEY
Credential	:
Telephone Number	:	509-662-1636

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	08/22/2020

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