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CRH PETERS CREEK LLC NPI 1356769293


NPI Information

NPI: 1356769293
Provider Name: CRH PETERS CREEK LLC

Doing Business As: PETERS CREEK

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 50D2195618

Address:
14431 REDMOND WAY
REDMOND, WA
ZIP 98052
Phone: (425) 869-2273
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CRH PETERS CREEK LLC is an assisted living facility in Redmond, WA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. CRH PETERS CREEK LLC NPI is 1356769293. The provider is registered as an organization entity type.
The provider Is Doing Business As Peters Creek.

The provider's business location address is:

14431 REDMOND WAY
REDMOND, WA
ZIP 98052-245
Phone: (425) 869-2273
Fax: (425) 861-1876

The provider's authorized official is Don Tavolacci .
The authorized official title is Managing Member and has the following contact phone number (541) 317-9188.

The CLIA number assigned to this NPI record is 50D2195618 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/28/2014 and was last updated on 10/7/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living Facility2245WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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