Provider Demographics
NPI:1841008448
Name:FRASCO & SARAUSAD BEVERLY LANE INC
Entity type:Organization
Organization Name:FRASCO & SARAUSAD BEVERLY LANE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:MR
Authorized Official - First Name:CESAR
Authorized Official - Middle Name:FRASCO
Authorized Official - Last Name:SARAUSAD
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:425-435-6594
Mailing Address - Street 1:931 12TH AVE N
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-2936
Mailing Address - Country:US
Mailing Address - Phone:425-435-6594
Mailing Address - Fax:206-238-9350
Practice Address - Street 1:5910 BEVERLY LN
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-3433
Practice Address - Country:US
Practice Address - Phone:425-374-7943
Practice Address - Fax:425-512-8941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-28
Last Update Date:2024-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home