Fountain Court Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

BH1568 Issued in WA

Legal business name

FOUNTAIN COURT ASSISTED LIVING

Practice address

24200 224TH Ave SE
Maple Valley, WA 98038-7926

Phone

(425) 432-3352

Fax

(425) 432-1648

NPI assigned

Apr 17, 2007

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

Kristi Knox

Title

Executive Director

Phone

(425) 432-3352

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336365543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 NE 77TH AVE",
            "address_2": "SUITE #132",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626789",
            "telephone_number": "360-449-4524",
            "fax_number": "360-449-4525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24200 224TH AVE SE",
            "city": "MAPLE VALLEY",
            "state": "WA",
            "postal_code": "980387926",
            "telephone_number": "425-432-3352",
            "fax_number": "425-432-1648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUNTAIN COURT ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KNOX",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "425-432-3352"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "BH1568",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "688752",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Maple Valley, WA
• Providers in Maple Valley, WA by specialty
• Assisted Living 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.