Provider Demographics
NPI:1366617193
Name:MULTICARE ADULT DAY HEALTH
Entity type:Organization
Organization Name:MULTICARE ADULT DAY HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HOME AND COMMUNITY SVCS
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:J
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-459-8330
Mailing Address - Street 1:PO BOX 5200
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98415-0200
Mailing Address - Country:US
Mailing Address - Phone:253-459-7222
Mailing Address - Fax:
Practice Address - Street 1:6442 YAKIMA AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98408-4599
Practice Address - Country:US
Practice Address - Phone:253-459-7222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MULTICARE HELATH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care