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Organization
PARADISE LAKE SENIOR CARE HOME, LLC
Active
Organization
PARADISE LAKE SENIOR CARE HOME, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA FRIGILLANA RN, BSN (AFH PROVIDER)
(425) 761-7739
Entity
Organization
Contact information
Practice address
10121 219TH ST SE, SNOHOMISH, WA 98296-4941
(425) 761-7739
(360) 668-5297
Mailing address
10121 219TH ST SE, SNOHOMISH, WA 98296-4941
(425) 761-7739
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
751477
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
515305
—
WA
Enumeration date
08/15/2014
Last updated
08/15/2014
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