# 1015 NORTH GARRISON, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Vancouver Specialty Rehabilitative Care, Vancouver Specialty and Reha
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811493364
- **Authorized official:** YEHUDA SCHMUKLER (MANAGER)
- **Authorized official phone:** (323) 350-7772

## Contact information

- **Practice address:** 1015 N GARRISON RD, VANCOUVER, WA 98664-1313
- **Practice address phone:** (360) 694-7501
- **Practice address fax:** (360) 694-8148
- **Mailing address:** 1015 N GARRISON RD, VANCOUVER, WA 98664-1313
- **Mailing address phone:** (360) 694-7501
- **Mailing address fax:** (360) 694-8148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 1572 | WA | Yes |

## Other

- **Enumeration date:** 04/03/2018
- **Last updated:** 08/13/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4115721 | — | WA |
| 01 | — | 505269 | MEDICARE OSCAR/CERTIFICATION | WA |
| 01 | — | 505269 | MEDICARE | — |