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Organization

PINECONE HEIGHTS CORPORATION

Active
Other names
Crest Manor AFH
Organization subpart
No

Provider details

NPI number
Authorized official
SUSAN J HOLLIDAY (PRESIDENT)
(206) 940-1020
Entity
Organization

Contact information

Practice address
1171 CAMAS AVE NE, RENTON, WA 98056-2918
(206) 940-1020
(425) 523-3990
Mailing address
10541 SE 226TH ST, KENT, WA 98031-2621
(206) 940-1020
(425) 523-3990

Taxonomy

Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
752487
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
320914
CLIENT SERVICE CONTRACT
WA
Enumeration date
10/09/2013
Last updated
10/09/2013
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