Organization
LIVE A LEGACY VENT CARE HOME, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANA NICORICI RN (OWNER)
(360) 828-1873
Entity
Organization
Contact information
Practice address
216 NE 151ST AVE, VANCOUVER, WA 98684-8171
(360) 828-1873
Mailing address
PO BOX 874045, VANCOUVER, WA 98687-4045
(360) 828-1873
(360) 838-8838
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
753086
WA
Other
Enumeration date
07/13/2016
Last updated
07/13/2016
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