Care Center (Sullivan Park) Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1345 Issued in WA

Legal business name

CARE CENTER (SULLIVAN PARK) INC

Practice address

14820 E 4TH Ave
Spokane Valley, WA 99216-2165

Phone

(509) 922-1644

Fax

(509) 922-8817

NPI assigned

Sep 22, 2005

Organization subpart

No

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

Authorized official

Name

Gregory J Vislocky

Title

Assistant to President/Ceo

Phone

(360) 735-7155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Sullivan Park Care Center Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie A Moran, M.D.

  • Family Medicine Physician
  • Deer Park, WA
  • NPI 1558367961
  NPD (past)
• Jordan Rafter, ARNP

  • Nurse Practitioner
  • Spokane Valley, WA
  • NPI 1760929160
  NPD (past)

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487640678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 NE PARKWAY DR",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626648",
            "telephone_number": "360-735-7155",
            "fax_number": "360-735-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14820 E 4TH AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "992162165",
            "telephone_number": "509-922-1644",
            "fax_number": "509-922-8817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE CENTER (SULLIVAN PARK) INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "VISLOCKY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ASSISTANT TO PRESIDENT/CEO",
        "authorized_official_telephone_number": "360-735-7155"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1345",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4110698",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sullivan Park Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kirsten Anna Campbell, PT
• Cancer Care Northwest Centers P S
• Luke Caplan
• Natalie Cardenas
• Maygen Katherine Cardona
• Alexandra Sarah Carey, M.D.
• Sabrina Carez
• Margaret Carfield, LMHC
• Deborah Carnett, LMHC
• Carol L Hathaway, M.D., P.S.

• Skilled Nursing Facility in Spokane Valley, WA
• Providers in Spokane Valley, 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.