# LONG TERM CARE DIVISION OF OCPHD 4

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- **Entity:** Organization
- **Status:** Active
- **Other names:** North Valley Extended Care
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528126091
- **Authorized official:** MR. ALAN ULRICH (CFO)
- **Authorized official phone:** (509) 486-3113

## Contact information

- **Practice address:** 22 W 1ST ST, TONASKET, WA 98855-8846
- **Practice address phone:** (509) 486-3152
- **Practice address fax:** (509) 486-3116
- **Mailing address:** 22 W 1ST ST, TONASKET, WA 98855-8846
- **Mailing address phone:** (509) 486-3152
- **Mailing address fax:** (509) 486-3116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | H-107 | WA | Yes |

## Other

- **Enumeration date:** 12/05/2006
- **Last updated:** 11/05/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4210704 | — | WA |