Provider Demographics
NPI:1831426352
Name:THE CAROLINE KLINE GALLAND HOME
Entity type:Organization
Organization Name:THE CAROLINE KLINE GALLAND HOME
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CHIEF OP OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:M
Authorized Official - Last Name:AN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-725-8800
Mailing Address - Street 1:7500 SEWARD PARK AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-4247
Mailing Address - Country:US
Mailing Address - Phone:206-725-8800
Mailing Address - Fax:206-722-5210
Practice Address - Street 1:7500 SEWARD PARK AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-4247
Practice Address - Country:US
Practice Address - Phone:206-725-8800
Practice Address - Fax:206-722-5210
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE CAROLINE KLINE GALLAND HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-11-04
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIHS.FS.60103742251G00000X, 315D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315D00000XNursing & Custodial Care FacilitiesHospice, Inpatient
No251G00000XAgenciesHospice Care, Community Based