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Organization
1015 NORTH GARRISON, LLC
Active
Organization
1015 NORTH GARRISON, LLC
Active
Other names
Vancouver Specialty Rehabilitative Care, Vancouver Specialty and Reha
Organization subpart
No
Provider details
NPI number
Authorized official
YEHUDA SCHMUKLER (MANAGER)
(323) 350-7772
Entity
Organization
Contact information
Practice address
1015 N GARRISON RD, VANCOUVER, WA 98664-1313
(360) 694-7501
(360) 694-8148
Mailing address
1015 N GARRISON RD, VANCOUVER, WA 98664-1313
(360) 694-7501
(360) 694-8148
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1572
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4115721
—
WA
01
—
505269
MEDICARE OSCAR/CERTIFICATION
WA
01
—
505269
MEDICARE
—
Enumeration date
04/03/2018
Last updated
08/13/2024
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