Provider Demographics
NPI:1689158123
Name:BISHOP CHESTERLEY LESSEE LLC
Entity Type:Organization
Organization Name:BISHOP CHESTERLEY LESSEE LLC
Other - Org Name:ELMCROFT OF CHESTERLEY
Other - Org Type:Other Name
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:MRS
Authorized Official - First Name:TRACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:GAMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-472-4067
Mailing Address - Street 1:9 W 57TH ST FL 43
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2700
Mailing Address - Country:US
Mailing Address - Phone:347-638-3172
Mailing Address - Fax:
Practice Address - Street 1:1100 N 35TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7355
Practice Address - Country:US
Practice Address - Phone:509-452-1010
Practice Address - Fax:509-248-2858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility