# ALDERCREST HEALTH - EDMONDS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Aldercrest Health & Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962575191
- **Authorized official:** DR. DOV E JACOBS (MANAGER)
- **Authorized official phone:** (323) 678-4426

## Contact information

- **Practice address:** 21400 72ND AVE W, EDMONDS, WA 98026-7702
- **Practice address phone:** (425) 775-1961
- **Practice address fax:** (425) 771-0116
- **Mailing address:** 21400 72ND AVENUE WEST, EDMONDS, WA 98026-7702
- **Mailing address phone:** (425) 774-1961
- **Mailing address fax:** (425) 771-0116

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 08/18/2017

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4194403 | — | WA |