Organization
GRAND PARK, LLC
Active
Other names
Cascade Park Active Day
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JANELLE RYAN MSW (PROGRAM ADMINISTRATOR)
(253) 627-9990
Entity
Organization
Contact information
Practice address
246 ST HELENS AVE, TACOMA, WA 98402-2522
(253) 627-9990
(253) 680-1961
Mailing address
246 ST HELENS AVE, TACOMA, WA 98402-2522
(253) 627-9990
(253) 680-1961
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
BH1251
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
570343
—
WA
Enumeration date
03/12/2014
Last updated
03/12/2014
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