Active NPI
Life Care Centers of America, Inc.
- Skilled Nursing Facility
- Bothell, WA
National Provider Identifier
1114971728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- License
- NH1126
- Legal business name
- LIFE CARE CENTERS OF AMERICA, INC.
- Practice address
- 707 228TH St SW
Bothell, WA 98021-9733 - Phone
- (425) 481-8500
- Fax
- (425) 487-2804
- NPI assigned
- May 19, 2006
- 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
- Cindy S. Cross
- Title
- Assistant Secretary
- Phone
- (423) 473-5867
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | NH1126 | WA | Primary |
Addresses
Primary practice location
707 228TH St SW
Bothell, WA 98021-9733
Mailing address
3001 Keith St NW
Cleveland, TN 37312-3713
Phone (423) 473-5751
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4111266 | Medicaid | WA |
Other names 1
- Life Care Center of Bothell
National Provider Directory
National Provider Directory- Tax ID family
- Bothell Health Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Skilled Nursing Facility
- Bothell, WA
- NPI 1568780120
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147996800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1631664000000",
"number": "1114971728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3001 KEITH ST NW",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373123713",
"telephone_number": "423-473-5751",
"fax_number": "423-339-8342"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 228TH ST SW",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980219733",
"telephone_number": "425-481-8500",
"fax_number": "425-487-2804"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LIFE CARE CENTERS OF AMERICA, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-19",
"last_updated": "2021-09-15",
"certification_date": "2021-09-15",
"status": "A",
"authorized_official_last_name": "CROSS",
"authorized_official_first_name": "CINDY",
"authorized_official_middle_name": "S.",
"authorized_official_title_or_position": "ASSISTANT SECRETARY",
"authorized_official_telephone_number": "423-473-5867"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": "WA",
"license": "NH1126",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4111266",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Life Care Center of Bothell",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Bothell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.