Provider Demographics
NPI:1144736547
Name:ELMVIEW
Entity Type:Organization
Organization Name:ELMVIEW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:
Authorized Official - Last Name:TABB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-899-0148
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-1909
Mailing Address - Country:US
Mailing Address - Phone:509-899-0148
Mailing Address - Fax:
Practice Address - Street 1:204 E 6TH AVE
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3136
Practice Address - Country:US
Practice Address - Phone:509-899-0148
Practice Address - Fax:509-962-5883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-20
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA251B00000X, 251E00000X, 253Z00000X, 332U00000X
251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No332U00000XSuppliersHome Delivered Meals