Pacifica Kenmore LLC
Assisted Living Facility in Kenmore, WA. Organization (NPI-2).
NPI number1275131237
StatusActive
Last updated in NPPESOct 13, 2020
Details
- NPI
- 1275131237
- Entity type
- Organization (NPI-2)
- Legal business name
- Pacifica Kenmore LLC
- Organization subpart
- No
- Enumeration date
- Oct 13, 2020
- Certification date
- Oct 13, 2020
- Last updated
- Oct 13, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
| 311500000X | Alzheimer Center (Dementia Center) | – | – |
Other names
- Kenmore Senior Living (Doing Business As)
Practice location
7221 Ne 182nd StreetKenmore, WA 98028
Phone 425-481-4200
Mailing address
1775 Hancock StreetSuite 200
San Diego, CA 92110
Phone 619-296-9000 · Fax 619-296-9090
Authorized official
Deepak Israni
General Manager
6192969000
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