MEDICARE: ESC III LP

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	310400000X	Assisted Living Facility	911781748	TX

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	:	1568684041
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ESC III LP

Provider Business Mailing Address
First Line	:	3131 ELLIOTT AVE STE 500
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98121-1032
Country	:	US
Telephone Number	:	206-298-2909
Fax Number	:	206-301-4500

Provider Business Practice Location Address
First Line	:	1831 MURCHISON
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79902
Country	:	US
Telephone Number	:	915-533-8271
Fax Number	:	915-533-1307

Authorized Official
Title or Position	:	LICENSING SPECIALIST
Name	:	NOELLE DIAZ BICKEL
Credential	:
Telephone Number	:	206-298-2909

Provider Enumeration Date	:	05/03/2007
Last Update Date	:	02/24/2010

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