Organization
CRESTWOOD CONVALESCENT - PORT ANGELES LLC
Active
Other names
Crestwood Health & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DOV JACOBS (MANAGER)
(323) 678-4426
Entity
Organization
Contact information
Practice address
1116 E LAURIDSEN BLVD, PORT ANGELES, WA 98362-6640
(360) 452-9206
(360) 457-2935
Mailing address
1116 EAST LAURIDSEN BOULEVARD, PORT ANGELES, WA 98362-6640
(360) 452-9206
(360) 457-2935
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4111688
—
WA
Enumeration date
11/14/2006
Last updated
08/18/2017
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