Organization · NPI-2

4755 South 48th Street Operations LLC

Skilled Nursing Facility · Tacoma, WA

NPI number1649654617
StatusActive
Last updated in NPPESMar 11, 2025

Details

NPI
1649654617
Entity type
Organization (NPI-2)
Legal business name
4755 South 48th Street Operations LLC
Organization subpart
No
Enumeration date
Jul 19, 2015
Certification date
Mar 11, 2025
Last updated
Mar 11, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
314000000X Skilled Nursing Facility1531WAYes

Other names

  • Orchard Park Health Care And Rehabilitation Center (Doing Business As)

Practice location

4755 S 48th St
Tacoma, WA 98409-1919

Phone 253-475-6600 · Fax 253-475-6611

Mailing address

4755 S 48th St
Tacoma, WA 98409-1919

Phone 253-475-6600 · Fax 253-475-6611

Authorized official

Avrohom Tress
Officer
7604450699

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