Organization
1015 NORTH GARRISON, LLC
Active
Other names
Vancouver Specialty Rehabilitative Care, Vancouver Specialty and Reha
Organization subpart
No
Provider details
NPI number
Authorized official
YEHUDA SCHMUKLER (MANAGER)
(323) 350-7772
Entity
Organization
Contact information
Practice address
1015 N GARRISON RD, VANCOUVER, WA 98664-1313
(360) 694-7501
(360) 694-8148
Mailing address
1015 N GARRISON RD, VANCOUVER, WA 98664-1313
(360) 694-7501
(360) 694-8148
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
1572
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4115721
—
WA
01
—
505269
MEDICARE OSCAR/CERTIFICATION
WA
01
—
505269
MEDICARE
—
Enumeration date
04/03/2018
Last updated
08/13/2024
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