Provider Demographics
NPI:1114217932
Name:ERA CARE AT I.C.H., INC.
Entity Type:Organization
Organization Name:ERA CARE AT I.C.H., INC.
Other - Org Name:IDA CULVER HOUSE, RAVENNA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ELI
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-470-8000
Mailing Address - Street 1:400 UNION ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2502
Mailing Address - Country:US
Mailing Address - Phone:206-470-8000
Mailing Address - Fax:206-470-8190
Practice Address - Street 1:2315 NE 65TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-7069
Practice Address - Country:US
Practice Address - Phone:206-523-7315
Practice Address - Fax:206-729-4972
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA858310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility