Organization
FMG CAPITOL MALL DRIVE SOUTHWEST WASHINGTON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C. KEATING (AGENT)
(414) 908-8058
Entity
Organization
Contact information
Practice address
4001 CAPITAL MALL DR SW, OLYMPIA, WA 98502-8657
(360) 754-9792
(360) 754-2455
Mailing address
5001 WEST LEMON STREET, C/O FOCUS MANAGEMENT GROUP, TAMPA, FL 33609-1103
(813) 281-0062
(813) 281-0063
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
12/18/2014
Last updated
07/21/2022
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