Organization
MANOR CARE OF LACEY WA, ASSOCIATION
Active
Other names
ProMedica Skilled Nursing and Rehabilitation (Lacey)
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARTIN D ALLEN (DIRECTOR)
(419) 252-5734
Entity
Organization
Contact information
Practice address
4524 INTELCO LOOP SE, LACEY, WA 98503-5941
(360) 491-9884
(360) 459-9836
Mailing address
333 N SUMMIT ST, TOLEDO, OH 43604-2615
(419) 252-5500
(877) 385-9446
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4114484
—
WA
Enumeration date
01/12/2012
Last updated
02/11/2022
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