Organization
PACIFICA KENMORE LLC
Active
Other names
Kenmore Senior Living
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPAK ISRANI (GENERAL MANAGER)
(619) 296-9000
Entity
Organization
Contact information
Practice address
7221 NE 182ND STREET, KENMORE, WA 98028
(425) 481-4200
Mailing address
1775 HANCOCK STREET, SUITE 200, SAN DIEGO, CA 92110
(619) 296-9000
(619) 296-9090
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
Other
Enumeration date
10/13/2020
Last updated
10/13/2020
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