Organization
CRESCENT CONVALESCENT CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MOLLY P FOSTER RN LNHA (OWNER/ADMINISTRATOR)
(509) 248-4446
Entity
Organization
Contact information
Practice address
505 N 40TH AVE, YAKIMA, WA 98908-2670
(509) 248-4446
(509) 453-2945
Mailing address
505 N 40TH AVE, YAKIMA, WA 98908-2670
(509) 248-4446
(509) 453-2945
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
472
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39701797000
UBI
WA
05
—
4147203
—
WA
01
—
472
STATE LICENSE
WA
Enumeration date
12/17/2005
Last updated
08/22/2020
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