Provider Demographics
NPI:1831366806
Name:LONG TERM CARE ALTERNATIVES, LLC
Entity type:Organization
Organization Name:LONG TERM CARE ALTERNATIVES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:TATUM
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:253-539-4520
Mailing Address - Street 1:1321 S 90TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-3190
Mailing Address - Country:US
Mailing Address - Phone:253-539-4520
Mailing Address - Fax:253-212-9121
Practice Address - Street 1:1421 S 86TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-4473
Practice Address - Country:US
Practice Address - Phone:253-539-4520
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA355700311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home