Provider Demographics
NPI:1457561623
Name:CASCADE LIVING GROUP
Entity Type:Organization
Organization Name:CASCADE LIVING GROUP
Other - Org Name:ASHLEY GARDENS
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHELLY
Authorized Official - Middle Name:GALE
Authorized Official - Last Name:HERREN
Authorized Official - Suffix:
Authorized Official - Credentials:EA
Authorized Official - Phone:360-419-9422
Mailing Address - Street 1:3807 E COLLEGE WAY
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-9182
Mailing Address - Country:US
Mailing Address - Phone:360-419-9422
Mailing Address - Fax:360-336-9256
Practice Address - Street 1:3807 E COLLEGE WAY
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-9182
Practice Address - Country:US
Practice Address - Phone:360-419-9422
Practice Address - Fax:360-336-9256
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home