# 400 29TH STREET NORTHEAST OPERATIONS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Linden Grove Health Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790160604
- **Authorized official:** MICHAEL T BERG (ASSISTANT SECRETARY)
- **Authorized official phone:** (505) 468-4742

## Contact information

- **Practice address:** 400 29TH ST NE, PUYALLUP, WA 98372-6774
- **Practice address phone:** (253) 840-4400
- **Practice address fax:** (253) 840-4411
- **Mailing address:** 400 29TH ST NE, PUYALLUP, WA 98372-6774
- **Mailing address phone:** (253) 840-4400
- **Mailing address fax:** (253) 840-4411

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 0000 | WA | Yes |

## Other

- **Enumeration date:** 07/22/2015
- **Last updated:** 07/22/2015