Provider Demographics
NPI:1851735039
Name:METHOW VALLEY FAMILY HOME CENTER ASSOCIATION
Entity type:Organization
Organization Name:METHOW VALLEY FAMILY HOME CENTER ASSOCIATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BRANDENBURG
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:509-996-4417
Mailing Address - Street 1:PO BOX 1260
Mailing Address - Street 2:109 NORFOLK ROAD
Mailing Address - City:WINTHROP
Mailing Address - State:WA
Mailing Address - Zip Code:98862
Mailing Address - Country:US
Mailing Address - Phone:509-996-4417
Mailing Address - Fax:509-996-4418
Practice Address - Street 1:109 NORFOLK ROAD
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:WA
Practice Address - Zip Code:98862
Practice Address - Country:US
Practice Address - Phone:509-996-4417
Practice Address - Fax:509-996-4418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-18
Last Update Date:2013-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA752367311ZA0620X
WA752368311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home