Provider Demographics
NPI:1083917165
Name:SL START & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:SL START & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-209-2777
Mailing Address - Street 1:5709 W SUNSET HWY
Mailing Address - Street 2:STE 100
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224
Mailing Address - Country:US
Mailing Address - Phone:509-328-2740
Mailing Address - Fax:509-789-3323
Practice Address - Street 1:901 N. MONROE STREET
Practice Address - Street 2:STE 200
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201
Practice Address - Country:US
Practice Address - Phone:509-328-2740
Practice Address - Fax:509-328-0773
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EMBASSY MANAGEMENT, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-12-13
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID1SLSTAR002-1251C00000X
261QD1600X, 385HR2060X
ID4SLSTAR054320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child