Provider Demographics
NPI:1093378358
Name:POPE'S KIDS PLACE
Entity Type:Organization
Organization Name:POPE'S KIDS PLACE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:BILLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-736-9178
Mailing Address - Street 1:230 WASHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:CENTRALIA
Mailing Address - State:WA
Mailing Address - Zip Code:98531-9225
Mailing Address - Country:US
Mailing Address - Phone:360-736-9178
Mailing Address - Fax:360-736-8312
Practice Address - Street 1:230 WASHINGTON WAY BLDG B
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:WA
Practice Address - Zip Code:98531-9225
Practice Address - Country:US
Practice Address - Phone:360-736-9178
Practice Address - Fax:360-736-8312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-22
Last Update Date:2019-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home