Provider Demographics
NPI:1033541313
Name:MT SI TRANSITIONAL HEALTH CENTER
Entity Type:Organization
Organization Name:MT SI TRANSITIONAL HEALTH CENTER
Other - Org Name:SELECT REHABILITATION
Other - Org Type:Other Name
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-888-2129
Mailing Address - Street 1:219 CEDAR AVE S
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:WA
Mailing Address - Zip Code:98045-8262
Mailing Address - Country:US
Mailing Address - Phone:425-888-2129
Mailing Address - Fax:
Practice Address - Street 1:219 CEDAR AVE S
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:WA
Practice Address - Zip Code:98045-8262
Practice Address - Country:US
Practice Address - Phone:425-888-2129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-08
Last Update Date:2013-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility