Provider Demographics
NPI:1780004838
Name:PARK PLACE RHF HOUSING
Entity Type:Organization
Organization Name:PARK PLACE RHF HOUSING
Other - Org Name:PARK PLACE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:L
Authorized Official - Last Name:FOLTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-722-7275
Mailing Address - Street 1:6900 37TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6425
Mailing Address - Country:US
Mailing Address - Phone:206-722-7275
Mailing Address - Fax:206-723-7275
Practice Address - Street 1:6900 37TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-6425
Practice Address - Country:US
Practice Address - Phone:206-722-7275
Practice Address - Fax:206-723-7275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABH1532310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA574818Medicaid