# CARE CENTER (SULLIVAN PARK) INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sullivan Park Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487640678
- **Authorized official:** GREGORY J VISLOCKY (ASSISTANT TO PRESIDENT/CEO)
- **Authorized official phone:** (360) 735-7155

## Contact information

- **Practice address:** 14820 E 4TH AVE, SPOKANE VALLEY, WA 99216-2165
- **Practice address phone:** (509) 922-1644
- **Practice address fax:** (509) 922-8817
- **Mailing address:** 7700 NE PARKWAY DR, SUITE 300, VANCOUVER, WA 98662-6648
- **Mailing address phone:** (360) 735-7155
- **Mailing address fax:** (360) 735-9416

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1345 | WA | Yes |

## Other

- **Enumeration date:** 09/22/2005
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4110698 | — | WA |