Care Center Union Gap Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CARE CENTER UNION GAP INC.

Doing business as

Prestige Care & Rehabilitation - Parkside

Practice address

308 W Emma St
Union Gap, WA 98903-1940

Phone

(509) 248-1985

Fax

(509) 248-9133

NPI assigned

Nov 15, 2012

Last updated

Jan 15, 2013By 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

Gregory J Vislocky

Title

Ex V.P. of Finance / Partner

Phone

(360) 735-7155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Prestige Care & Rehabilitation - Parkside Doing business as

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": "1730423757",
    "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": "308 W EMMA ST",
            "city": "UNION GAP",
            "state": "WA",
            "postal_code": "989031940",
            "telephone_number": "509-248-1985",
            "fax_number": "509-248-9133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARE CENTER UNION GAP 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 V.P. OF FINANCE / PARTNER",
        "authorized_official_telephone_number": "360-735-7155"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4114586",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prestige Care & Rehabilitation - Parkside",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jodi Linn Bailey
• Sherry Briggs, RN
• Charles Vaughan Bulfinch, D.O.
• Risa Naomi Campos, DNP, ARNP, FNP-C
• Isrrael Felix Cardenas Rodriguez
• Lizet Carpenter
• Yvette Chapman
• Kathi Marie Christensen-Manneh, LMP
• Krystal R Clemmons
• Cole Vision Corporation (Sears Optical #C0182)

• Skilled Nursing Facility in Union Gap, WA
• Providers in Union Gap, 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.