Organization
SSA VII, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEE FIELD (MEMBER)
(253) 474-0425
Entity
Organization
Contact information
Practice address
13400 N MEYER RD, RATHDRUM, ID 83858-7099
(208) 687-0495
Mailing address
1201 PACIFIC AVE STE 450, TACOMA, WA 98402-4382
(253) 474-0425
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
311ZA0620X
Adult Care Home Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RC-1147
IDAHO DEPARTMENT OF HEALTH AND WELFARE
ID
Enumeration date
05/22/2017
Last updated
07/20/2017
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