PACIFICA SENIOR LIVING MILTON LLC (NPI# 1063011880) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063011880 |
| Entity Type | Organization |
| Organization Name | PACIFICA SENIOR LIVING MILTON LLC |
| Practice Address |
1111 S 376th St Milton WA 98354-5501 |
| Practice Telephone | 2536613651 |
| Mailing Telephone | 2536613651 |
| Enumeration Date | 2020-10-22 |
| Last Update Date | 2020-10-22 |
| Authorized Official Name | DEEPAK ISRANI (OWNER) |
| Authorized Official Telephone | 6192969000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Meridian At Stone Creek | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | PACIFICA SENIOR LIVING MILTON LLC | 1775 Hancock St Ste 200, San Diego, CA 92110-2036 |
| Street Address |
1111 S 376TH ST |
| City | MILTON |
| State | WA |
| Zip Code | 98354-5501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205470051 | Jessica Miller | Physical Therapy Assistant | 1111 S 376th St, Milton, WA 98354-5501 | 2019-11-05 |
| 1902420755 | Breauna Pederson | Physical Therapy Assistant | 1111 S 376th St, Milton, WA 98354-5501 | 2020-06-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427682616 | Heather Church | Massage Therapist | 724 Meridian Ave #1, Milton, WA 98354 | 2020-02-26 |
| 1134769839 | Chidimma Okoye | Registered Nurse | 7224 Pacific High Way E, Milton, WA 98354 | 2020-01-10 |
| 1811536717 | Mark Hennecken | Licensed Practical Nurse | 7224 Pacific Hwy E., Milton, WA 98354 | 2019-12-26 |
| 1609418672 | Erin Kim Lorentzen | Counselor | 7224 Pacific Hwy E, Milton, WA 98354 | 2019-10-11 |
| 1598306243 | Kelly Jean Murray | Counselor | 7224 Pacific Hwy East, Milton, WA 98354 | 2019-10-03 |
| 1578025359 | Kiet Do | Counselor | 7224 Pacific Hwy. E, Milton, WA 98354 | 2019-04-02 |
| 1568936557 | Telecare Mental Health Services of Washington, Inc. | Psychiatric Residential Treatment Facility | 7224 Pacific Highway East, Milton, WA 98354 | 2019-01-14 |
| 1194178418 | Bryan Vaught | Occupational Therapy Assistant | 2830 Queens Way, Apt E1, Milton, WA 98354 | 2016-07-21 |
| 1730485459 | Barbara Lyn Bishop | Mechanotherapist | 2411 14th Avenue, Milton, WA 98354 | 2011-01-27 |
| 1669774865 | Ha T Hoang | Pharmacist | 900 East Meridian, Milton, WA 98354 | 2010-11-22 |
| Find all providers in zip 98354 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| 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. |
| Notes: [7/1/2003: new] |
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|---|---|---|---|---|
| 1073773081 | Rushan Corporation | Assisted Living Facility | 5544 Swanner Rd, Milton, FL 32570-4069 | 2008-06-12 |
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| 1104443001 | Gig Harbor Ventures, L.L.C. | Assisted Living Facility | 3025 14th Ave Nw, Gig Harbor, WA 98335-1635 | 2020-06-26 |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.