Provider Demographics
NPI:1003027350
Name:CASCADE INN, LP
Entity Type:Organization
Organization Name:CASCADE INN, LP
Other - Org Name:KOELSCH SENIOR COMMUNITIES, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT, OPERATION
Authorized Official - Prefix:
Authorized Official - First Name:GARTH
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:BRANDT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-867-1900
Mailing Address - Street 1:4912 KEATING RD NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-9535
Mailing Address - Country:US
Mailing Address - Phone:360-867-1900
Mailing Address - Fax:360-867-1956
Practice Address - Street 1:11613 SE 7TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-5213
Practice Address - Country:US
Practice Address - Phone:360-254-3555
Practice Address - Fax:360-253-2727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA784385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care