Provider Demographics
NPI:1821113093
Name:CASCADE PLAZA RETIREMENT AND ASSISTED LIVING CENTER
Entity Type:Organization
Organization Name:CASCADE PLAZA RETIREMENT AND ASSISTED LIVING CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CAFFEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-885-4157
Mailing Address - Street 1:7950 WILLOWS RD NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98052-6813
Mailing Address - Country:US
Mailing Address - Phone:425-885-4157
Mailing Address - Fax:425-882-3308
Practice Address - Street 1:7950 WILLOWS RD NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-6813
Practice Address - Country:US
Practice Address - Phone:425-885-4157
Practice Address - Fax:425-882-3308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WABH884310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility