Organization Active NPI

Callaway Gardens Management Wa LLC

  • Assisted Living Facility
  • Kennewick, WA
National Provider Identifier
1003357096
Registry record updated Mar 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
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

Updated by the provider on Mar 10, 2017

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)CodeLicenseStatePrimary
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 Doing business as

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.