Provider Demographics
NPI:1538459359
Name:UNIVERSITY HOUSE AT WALLINGFORD, L.L.C.
Entity Type:Organization
Organization Name:UNIVERSITY HOUSE AT WALLINGFORD, L.L.C.
Other - Org Name:UNIVERSITY HOUSE, WALLINGFORD
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELI
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-470-8000
Mailing Address - Street 1:400 UNION ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2502
Mailing Address - Country:US
Mailing Address - Phone:206-470-8000
Mailing Address - Fax:206-470-8190
Practice Address - Street 1:4400 STONE WAY N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-7485
Practice Address - Country:US
Practice Address - Phone:206-545-8400
Practice Address - Fax:206-545-2887
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1170310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility