Care Center Colville Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

1303 Issued in WA

Legal business name

CARE CENTER COLVILLE INC.

Practice address

1000 E Elep Ave
Colville, WA 99114-5014

Phone

(509) 684-2573

Fax

(509) 685-2234

NPI assigned

Nov 15, 2012

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

Ex VP of Finance / Partner

Phone

(360) 735-7155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prestige Care & Rehabilitation - Pinewood Terrace Doing business as

Locations

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358208000000",
    "number": "1699019711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 NE PARKWAY DRIVE",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626654",
            "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": "1000 E ELEP AVE",
            "city": "COLVILLE",
            "state": "WA",
            "postal_code": "991145014",
            "telephone_number": "509-684-2573",
            "fax_number": "509-685-2234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE CENTER COLVILLE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2013-01-15",
        "status": "A",
        "authorized_official_last_name": "VISLOCKY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EX VP OF FINANCE / PARTNER",
        "authorized_official_telephone_number": "360-735-7155"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "WA",
            "license": "1303",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4114578",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Care & Rehabilitation - Pinewood Terrace",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Megan D Camp
• Ramon G Canto, MD
• Susan C Canto, RC
• Candice M Capoeman, NAC
• Richard Jason Cardenas, PHYSICIAN ASSISTANT
• Sara J Carle
• Jessica Carpenter, PHARMD
• Margaret M Carson, RN
• Marlita Chantry, PT
• Billi Gene Christensen

• Skilled Nursing Facility in Colville, WA
• Providers in Colville, 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 Jan 15, 2013; 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.