Provider Demographics
NPI:1073501847
Name:WARM BEACH HEALTH CARE CENTER INC.
Entity Type:Organization
Organization Name:WARM BEACH HEALTH CARE CENTER INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HEALTHCARE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-652-2600
Mailing Address - Street 1:20420 MARINE DR
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-6116
Mailing Address - Country:US
Mailing Address - Phone:360-652-2608
Mailing Address - Fax:360-652-2622
Practice Address - Street 1:20420 MARINE DR
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-6116
Practice Address - Country:US
Practice Address - Phone:360-652-2608
Practice Address - Fax:360-652-2622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
310400000X
WA645314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA4164505Medicaid
WA4164505Medicaid