Provider Demographics
NPI:1346598299
Name:CARE CENTER (LEWISTON) INC.
Entity Type:Organization
Organization Name:CARE CENTER (LEWISTON) INC.
Other - Org Name:THE ORCHARDS REHABILITATION & CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EX VP OF FINANCE / PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VISLOCKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-816-8295
Mailing Address - Street 1:7700 NE PARKWAY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6654
Mailing Address - Country:US
Mailing Address - Phone:360-735-7155
Mailing Address - Fax:360-735-9416
Practice Address - Street 1:1014 BURRELL AVE
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ID
Practice Address - Zip Code:83501-5589
Practice Address - Country:US
Practice Address - Phone:208-743-4558
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-27
Last Update Date:2012-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID135103Medicare Oscar/Certification