Organization
EXTENDICARE HOMES, INC.
Active
Other names
Cherrywood Place
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA JO MAASSEN (DIRECTOR OF COMPLIANCE)
(414) 908-8119
Entity
Organization
Contact information
Practice address
100 E DALKE AVE, SPOKANE, WA 99208-1006
(509) 484-3553
(509) 484-3585
Mailing address
111 W MICHIGAN ST, MILWAUKEE, WI 53203-2903
(414) 908-8119
(414) 908-7105
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
BH812
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
127182
—
WA
Enumeration date
12/27/2006
Last updated
04/07/2008
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