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NPI Code Detail

MEDICARE: HEARTWOOD EXTENDED HEALTH CARE LLC

MEDICARE: HEARTWOOD EXTENDED HEALTH CARE 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
1314000000XSkilled Nursing Facility1308WA

Other Identifiers

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

General Provider Information

NPI Number : 1801896436
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEARTWOOD EXTENDED HEALTH CARE LLC
Provider Business Mailing Address
First Line : 1649 E 72ND ST
Second Line :
City : TACOMA
State : WA
Zip : 98404-5402
Country : US
Telephone Number : 253-472-9027
Fax Number : 253-475-8206
Provider Business Practice Location Address
First Line : 1649 E 72ND ST
Second Line :
City : TACOMA
State : WA
Zip : 98404-5402
Country : US
Telephone Number : 253-472-9027
Fax Number : 253-475-8206
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. NANCY K. ROWE
Credential :
Telephone Number : 253-472-9027
Provider Enumeration Date : 07/26/2005
Last Update Date : 08/22/2020

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Directions to “HEARTWOOD EXTENDED HEALTH CARE LLC ” Practice Location

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