Organization
THE 13TH STREET HOUSE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA A WOLD NAR (ADMINISTRATOR)
(360) 260-2686
Entity
Organization
Contact information
Practice address
19917 NE 13TH ST, CAMAS, WA 98607-7678
(360) 260-2686
(360) 397-0483
Mailing address
19917 NE 13TH ST, CAMAS, WA 98607-7678
(360) 260-2686
(360) 397-0483
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
750770
WA
Other
Enumeration date
04/13/2008
Last updated
04/13/2008
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