SULLIVAN VENTURES LLC NPI 1942337068

NPI Information

NPI: 1942337068
Provider Name: SULLIVAN VENTURES LLC

Doing Business As: SULLIVAN PARK ASSISTED LIVING COMMUNITY

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
421 S ADAMS RD
SPOKANE VALLEY, WA
ZIP 99216
Phone: (509) 924-5555
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SULLIVAN VENTURES LLC is an assisted living facility in Spokane Valley, WA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. SULLIVAN VENTURES LLC NPI is 1942337068. The provider is registered as an organization entity type.
The provider Is Doing Business As Sullivan Park Assisted Living Community.

The provider's business location address is:

421 S ADAMS RD
SPOKANE VALLEY, WA
ZIP 99216-121
Phone: (509) 924-5555
Fax: (509) 924-8890

The provider's authorized official is Gregory J Vislocky .
The authorized official title is Managing Member and has the following contact phone number (360) 735-7155.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310400000X	Assisted Living Facility		1612	WASHINGTON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	966047	MEDICAID	WASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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