Organization
820 NW 95TH STREET OPERATIONS LLC
Active
Other names
BALLARD CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T BERG ASST SECRETARY (AUTHORIZED OFFICIAL)
(505) 468-4742
Entity
Organization
Contact information
Practice address
820 NW 95TH ST, SEATTLE, WA 98117-2207
(206) 782-0100
(206) 782-0101
Mailing address
820 NW 95TH ST, SEATTLE, WA 98117-2207
(206) 782-0100
(206) 782-0101
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1441
LICENSE
WA
05
—
4114419
—
WA
Enumeration date
07/16/2019
Last updated
07/16/2019
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