Revera (Delaware) LLC
Skilled Nursing Facility in Puyallup, Washington
1417959875- Practice location
- 400 29TH Street NE, Puyallup, WA 98372-6774
- Phone
- 253-840-4400
- Fax
- 253-840-6733
- Last updated
- May 19, 2011
Revera (Delaware) LLC is a healthcare organization based in Puyallup, WA. Revera (Delaware) LLC practices in Puyallup, WA. The NPI Number for Revera (Delaware) LLC is 1417959875 and holds a License No. NH1257 (WA). The current practice location address for Revera (Delaware) LLC is 400 29TH Street NE, Puyallup, WA 98372-6774 and can be reached out via phone at 253-840-4400 and via fax at 253-840-6733.
Provider Profile Details
- NPI Number
- 1417959875
- Provider Name
- Revera (Delaware) LLC
- Provider Entity Type
- Organization
- Address
- 400 29TH Street NE, Puyallup, WA 98372-6774
- Phone Number
- 253-840-4400
- Fax Number
- 253-840-6733
- Primary Taxonomy
- Skilled Nursing Facility · 314000000X
- Organization Subpart
- No
- Authorized Official
- Carole M Scillia · LLC Manager · 860-347-6300
- Other Names
- Linden Grove Health Care Center (Doing Business As)
- Provider Enumeration Date
- August 15, 2005
- Last Update Date
- May 19, 2011
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 400 29TH Street NE
Puyallup, WA 98372-6774 - City
- Puyallup
- State
- Washington
- Zip
- 98372-6774
- Phone Number
- 253-840-4400
- Fax Number
- 253-840-6733
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)
- NH1257
- License State (1)
- WA
- Taxonomy (1)
- Skilled Nursing Facility · 314000000X
- License Number (2)
- 1257
- License State (2)
- WA
- Taxonomy (2)
- Skilled Nursing Facility · 314000000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 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 1417959875. It was assigned on August 15, 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 NH1257.
Where does Revera (Delaware) LLC practice?
The practice location is 400 29TH Street NE, Puyallup, WA 98372-6774. The office can be reached at 253-840-4400 (phone) or 253-840-6733 (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 1417959875 directly on the NPPES registry website.