Provider Demographics
NPI:1336310663
Name:THE WOODMARK AT STEEL LAKE LLC
Entity Type:Organization
Organization Name:THE WOODMARK AT STEEL LAKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FLAVIA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAGRANGE
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:253-941-5859
Mailing Address - Street 1:31200 23RD AVE S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5533
Mailing Address - Country:US
Mailing Address - Phone:253-941-5859
Mailing Address - Fax:253-941-3470
Practice Address - Street 1:31200 23RD AVE S
Practice Address - Street 2:SUITE 100
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5533
Practice Address - Country:US
Practice Address - Phone:253-941-5859
Practice Address - Fax:253-941-3470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-14
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1142310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility