Active NPI
Callaway Gardens Management Wa LLC
- Assisted Living Facility
- Kennewick, WA
National Provider Identifier
1003357096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- Legal business name
- CALLAWAY GARDENS MANAGEMENT WA LLC
- Practice address
- 5505 W Skagit CT
Kennewick, WA 99336-1374 - Phone
- (509) 783-5433
- NPI assigned
- Mar 10, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Trent Johnson
- Title
- Manager
- Phone
- (469) 804-3716
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | Primary |
Addresses
Primary practice location
5505 W Skagit CT
Kennewick, WA 99336-1374
Mailing address
200 Crescent CT Ste 440
Dallas, TX 75201-6964
Other names 1
- Callaway Gardens Alzheimers Special Care Center
National Provider Directory
National Provider DirectoryLocations
200 Crescent Ct
Ste 440
Dallas, TX 75201
5505 W Skagit Ct
Kennewick, WA 99336
Phone (509) 736-6367
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489104000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1489104000000",
"number": "1003357096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 CRESCENT CT STE 440",
"city": "DALLAS",
"state": "TX",
"postal_code": "752016964"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5505 W SKAGIT CT",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993361374",
"telephone_number": "509-783-5433"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CALLAWAY GARDENS MANAGEMENT WA LLC",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-10",
"last_updated": "2017-03-10",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "TRENT",
"authorized_official_title_or_position": "MANAGER",
"authorized_official_telephone_number": "469-804-3716"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Callaway Gardens Alzheimers Special Care Center",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.