Selah Convalescent, Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1108 Issued in WA

Legal business name

SELAH CONVALESCENT, INC.

Practice address

203 W Naches Ave
Selah, WA 98942-1325

Phone

(509) 697-8503

Fax

(509) 697-4558

NPI assigned

Oct 12, 2005

Organization subpart

No

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

Authorized official

Name

Ms. Carol J. Hyatt

Title

Owner/Administrator

Phone

(509) 697-8503

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303948800000",
    "number": "1396733440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 W NACHES AVE",
            "address_2": "PO BOX 157",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989421325",
            "telephone_number": "509-697-8503",
            "fax_number": "509-697-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W NACHES AVE",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989421325",
            "telephone_number": "509-697-8503",
            "fax_number": "509-697-4558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELAH CONVALESCENT, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-12",
        "last_updated": "2011-04-28",
        "status": "A",
        "authorized_official_last_name": "HYATT",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "509-697-8503",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1108",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4111084",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Selah, WA
• Providers in Selah, 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 Apr 28, 2011; 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.