Provider Demographics
NPI:1356709554
Name:CALICHE OPERATIONS
Entity type:Organization
Organization Name:CALICHE OPERATIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:DENDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-882-4500
Mailing Address - Street 1:201 NE PARK PLAZA DR STE 105
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684-5874
Mailing Address - Country:US
Mailing Address - Phone:360-882-4500
Mailing Address - Fax:360-882-4501
Practice Address - Street 1:1640 NORTH PEART ROAD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122
Practice Address - Country:US
Practice Address - Phone:360-882-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-02
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility