Provider Demographics
NPI:1942653027
Name:CARE CENTER WENATCHEE INC
Entity Type:Organization
Organization Name:CARE CENTER WENATCHEE INC
Other - Org Name:COLONIAL VISTA POST-ACUTE & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EX VP OF FINANCE / PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:VISLOCKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-735-7155
Mailing Address - Street 1:7700 NE PARKWAY DR
Mailing Address - Street 2:STE 300
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6648
Mailing Address - Country:US
Mailing Address - Phone:360-816-8283
Mailing Address - Fax:360-816-8258
Practice Address - Street 1:625 OKANOGAN AVE
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-6409
Practice Address - Country:US
Practice Address - Phone:509-663-1171
Practice Address - Fax:509-664-6864
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PRESTIGE SENIOR LIVING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-13
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA505413Medicare Oscar/Certification