Provider Demographics
NPI:1184738247
Name:SPOKANE UNITED METHODIST HOMES
Entity type:Organization
Organization Name:SPOKANE UNITED METHODIST HOMES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT FINANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-536-6658
Mailing Address - Street 1:2903 E 25TH AVE STE OFC
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4963
Mailing Address - Country:US
Mailing Address - Phone:509-536-6650
Mailing Address - Fax:509-536-6662
Practice Address - Street 1:2903 E 25TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4992
Practice Address - Country:US
Practice Address - Phone:509-536-6650
Practice Address - Fax:509-536-6662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA457314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA505033Medicare ID - Type UnspecifiedPROVIDER NUMBER