Active NPIOrganization

Revera (Delaware) LLC

Skilled Nursing Facility in Tacoma, Washington

NPI Number1225029887
Practice location
4755 S 48TH Street, Tacoma, WA 98409-1919
Fax
253-471-9591
Last updated
May 20, 2011

Revera (Delaware) LLC is a healthcare organization based in Tacoma, WA. Revera (Delaware) LLC practices in Tacoma, WA. The NPI Number for Revera (Delaware) LLC is 1225029887 and holds a License No. NH1259 (WA). The current practice location address for Revera (Delaware) LLC is 4755 S 48TH Street, Tacoma, WA 98409-1919 and can be reached out via phone at 253-475-4611 and via fax at 253-471-9591.

Provider Profile Details

NPI Number
1225029887
Provider Name
Revera (Delaware) LLC
Provider Entity Type
Organization
Address
4755 S 48TH Street, Tacoma, WA 98409-1919
Phone Number
253-475-4611
Fax Number
253-471-9591
Primary Taxonomy
Skilled Nursing Facility · 314000000X
Organization Subpart
No
Authorized Official
Carole M Scillia · LLC Manager · 203-608-6100
Other Names
Orchard Park Health And Rehabilitation Center (Doing Business As)
Provider Enumeration Date
November 2, 2005
Last Update Date
May 20, 2011
NPI Status
Active

Provider Business Practice Location Address Details

Address
4755 S 48TH Street
Tacoma, WA 98409-1919
City
Tacoma
Zip
98409-1919
Phone Number
253-475-4611
Fax Number
253-471-9591
Tacoma, WA 98409Get directions →

Provider Business Mailing Address Details

Address
538 Preston Ave
Suite 270
Meriden, CT 06450-4851
City
Meriden
State
CT
Zip
06450-4851
Phone Number
203-608-6100
Fax Number
203-639-3574

License Information

License Number (1)
NH1259
License State (1)
WA
Taxonomy (1)
Skilled Nursing Facility · 314000000X
License Number (2)
1259
License State (2)
WA
Taxonomy (2)
Skilled Nursing Facility · 314000000X · Primary

Legacy Identifiers

IdentifierTypeStateIssuer
No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider.

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Frequently Asked Questions

What is the NPI number of Revera (Delaware) LLC?

The NPI number of Revera (Delaware) LLC is 1225029887. It was assigned on November 2, 2005 and is currently active in the NPPES registry.

What is the specialty of Revera (Delaware) LLC?

Revera (Delaware) LLC is registered under the primary taxonomy Skilled Nursing Facility (code 314000000X), licensed in WA under license number NH1259.

Where does Revera (Delaware) LLC practice?

The practice location is 4755 S 48TH Street, Tacoma, WA 98409-1919. The office can be reached at 253-475-4611 (phone) or 253-471-9591 (fax).

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.

How do I verify this NPI record?

This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1225029887 directly on the NPPES registry website.

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