Provider Demographics
NPI:1437557436
Name:WC-BREMERTON OPS, LLC
Entity Type:Organization
Organization Name:WC-BREMERTON OPS, LLC
Other - Org Name:CLAREMONT SENIOR LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PEDER
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-377-1717
Mailing Address - Street 1:2707 CLARE AVE
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3337
Mailing Address - Country:US
Mailing Address - Phone:360-377-1717
Mailing Address - Fax:360-479-0527
Practice Address - Street 1:2707 CLARE AVE
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3337
Practice Address - Country:US
Practice Address - Phone:360-377-1717
Practice Address - Fax:360-479-0527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-08
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility