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NPI Code Detail

MEDICARE: SW ASSISTED LIVING, LLC

MEDICARE: SW ASSISTED LIVING, 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
1310400000XAssisted Living Facility0100CT

General Provider Information

NPI Number : 1851523344
Entity Type Code : Organization
Provider Name (Legal Business Name) : SW ASSISTED LIVING, LLC
Provider Business Mailing Address
First Line : 3131 ELLIOTT AVE
Second Line : SUITE 500
City : SEATTLE
State : WA
Zip : 98121-1044
Country : US
Telephone Number : 206-298-2909
Fax Number : 206-301-4500
Provider Business Practice Location Address
First Line : 1715 ELLINGTON RD
Second Line :
City : SOUTH WINDSOR
State : CT
Zip : 06074-2707
Country : US
Telephone Number : 860-644-4408
Fax Number : 860-664-4448
Authorized Official
Title or Position : LICENSING SPECIALIST
Name : NOELLE DIAZ
Credential :
Telephone Number : 206-301-4060
Provider Enumeration Date : 08/17/2009
Last Update Date : 08/17/2009

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Directions to “SW ASSISTED LIVING, LLC ” Practice Location

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