Provider Demographics
NPI:1366866626
Name:WEEPING RIDGE NORTH,LLC
Entity Type:Organization
Organization Name:WEEPING RIDGE NORTH,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINASTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ISRAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RODRIGUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-989-1843
Mailing Address - Street 1:PO BOX 139
Mailing Address - Street 2:
Mailing Address - City:OTHELLO
Mailing Address - State:WA
Mailing Address - Zip Code:99344-0139
Mailing Address - Country:US
Mailing Address - Phone:509-989-1843
Mailing Address - Fax:509-488-3400
Practice Address - Street 1:10226 N SEMINOLE DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-8631
Practice Address - Country:US
Practice Address - Phone:509-989-1843
Practice Address - Fax:509-989-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric