Provider Demographics
NPI:1285836544
Name:ESC IV, LP
Entity Type:Organization
Organization Name:ESC IV, LP
Other - Org Name:EMERITUS AT SEVILLE ESTATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LICENSING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:NOELLE
Authorized Official - Middle Name:DIAZ
Authorized Official - Last Name:BICKEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-298-2909
Mailing Address - Street 1:3131 ELLIOTT AVE
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-1032
Mailing Address - Country:US
Mailing Address - Phone:206-301-4500
Mailing Address - Fax:206-301-4500
Practice Address - Street 1:7401 SEVILLE DRIVE
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79121-1821
Practice Address - Country:US
Practice Address - Phone:206-301-4500
Practice Address - Fax:206-301-4500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2009-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114932311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility