Bonaventure of Lacey

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

BONAVENTURE OF LACEY

Practice address

4528 Intelco Loop SE
Lacey, WA 98503-5916

Phone

(360) 455-8500

NPI assigned

Apr 13, 2023

Organization subpart

No

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

Authorized official

Name

Denise Jeanine Link

Title

Accounts Receivable Specialist

Phone

(503) 371-3131

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1681344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681344000000",
    "number": "1588350466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3425 BOONE RD SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973179336",
            "telephone_number": "503-373-3131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4528 INTELCO LOOP SE",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985035916",
            "telephone_number": "360-455-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONAVENTURE OF LACEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-13",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A",
        "authorized_official_last_name": "LINK",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "JEANINE",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE SPECIALIST",
        "authorized_official_telephone_number": "503-371-3131"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Marie Blume
• Body Essentials, LLC
• Bodywork and Massage Center (Organic Wellness)
• Jeremy Craig Bolden, MSW
• Whitney Michelle Boling, LMP
• Carlos Bonilla
• Julieta Quia Bonilla, RN
• Erica Bonte
• Emily Chepngeno Bor, BSN,RN
• Kerri Borden, CC

• Assisted Living Facility in Lacey, WA
• Providers in Lacey, 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 Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.