Organization
BUENA VISTA INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRI CARTER (ADMINISTRATOR)
(509) 684-4539
Entity
Organization
Contact information
Practice address
151 BUENA VISTA DR, COLVILLE, WA 99114-8676
(509) 684-4539
(509) 685-0582
Mailing address
151 BUENA VISTA DR, COLVILLE, WA 99114-8676
(509) 684-4539
(509) 684-6013
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
BH 1023
WA
314000000X
Skilled Nursing Facility
Primary
NH 1244
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127682
SSPS#
WA
05
—
4112447
—
WA
Enumeration date
07/07/2005
Last updated
03/11/2014
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