Laurel Hill Enterprises

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

4112850 Issued in WA

Legal business name

LAUREL HILL ENTERPRISES

Doing business as

Regency at The Park

Practice address

420 SE Myra Rd
College Place, WA 99324-1796

Phone

(509) 529-4480

Fax

(509) 529-8776

NPI assigned

Oct 31, 2005

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Larry M White

Title

Administrator

Phone

(509) 529-4480

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Regency at The Park Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174514046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 SE MYRA RD",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993241796",
            "telephone_number": "509-529-4480",
            "fax_number": "509-529-8776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 SE MYRA RD",
            "city": "COLLEGE PLACE",
            "state": "WA",
            "postal_code": "993241796",
            "telephone_number": "509-529-4480",
            "fax_number": "509-529-8776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL HILL ENTERPRISES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "509-529-4480",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "4112850",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4112850",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regency at The Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in College Place, WA
• Providers in College Place, WA by specialty
• Skilled Nursing Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.