FMG EAST LAURIDSEN BOULEVARD WASHINGTON LLC


Address: 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640
Phone: 3604529206

FMG EAST LAURIDSEN BOULEVARD WASHINGTON LLC (NPI# 1629476916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1629476916
Entity Type Organization
Organization Name FMG EAST LAURIDSEN BOULEVARD WASHINGTON LLC
Other Organization Name CRESTWOOD HEALTH & REHABILITATION CENTER
Practice Address 1116 E Lauridsen Blvd
Port Angeles
WA 98362-6640
Mailing Address 5001 West Lemon Street
C/o Focus Management Group
Tampa
FL 33609-1103
Practice Telephone 3604529206
Practice Fax Number 3604572935
Mailing Telephone (813) 281-0062
Mailing Fax Number 8132810063
Enumeration Date 2014-12-18
Last Update Date 2017-11-07
Authorized Official Name DAVID C. KEATING (AGENT)
Authorized Official Telephone 4149088058
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 314000000X Skilled Nursing Facility Nursing & Custodial Care Facilities

Other Provider/Organization Names

Other Name Type Code
Crestwood Health & Rehabilitation Center Doing Business As Name - Organization

Office Location

Street Address 1116 E LAURIDSEN BLVD
City PORT ANGELES
State WA
Zip Code 98362-6640

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417029885 Crestwood Convalescent - Port Angeles LLC Skilled Nursing Facility 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2006-11-14
1396253274 Stacey Steele Occupational Therapy Assistant 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2018-01-13
1871006601 Crestwood Convalescent - Port Angeles LLC Skilled Nursing Facility 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2017-11-15
1437669413 Justin Ford Walker Speech-Language Pathologist 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2017-10-04
1659808921 Matthew Patrick Malloy Physical Therapy Assistant 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2017-05-17
1659721520 Lindsey Marsaw Physical Therapy Assistant 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2016-06-21
1487069001 Hannah Louise Carroll Physical Therapy Assistant 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2014-06-23
1851712129 Asa Addison Harris Physical Therapy Assistant 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2014-01-03
1801217161 Patrick Dewitt Occupational Therapy Assistant 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2014-01-03
1982025243 Larry Hurd Occupational Therapy Assistant 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2014-01-03
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1831735778 Jayme Marie Williams Technician 518 S. Liberty St., Port Angeles, WA 98362 2019-11-26
1780229559 Barbara Amsler Nutrition, Pllc Dietitian, Registered 320 E. 5th St., Port Angeles, WA 98362 2019-11-15
1902315005 Barbara Amsler Nutritionist 116 S. Ennis St, Port Angeles, WA 98362 2017-09-21
1134659667 Janet Li Hanson Registered Nurse 532 South Alder Lane, Port Angeles, WA 98362 2017-06-18
1790220192 Monica Kay Henry Massage Therapist 102 1/2 East 1st Street Suite #7, Port Angeles, WA 98362 2016-12-21
1124491725 Gabrielle Carter Naturopath 1126 Columbia St, Port Angeles, WA 98362 2015-11-04
1912301185 Danya Lyn Davis Massage Therapist 106 W. Lauridsen Blvd., Port Angeles, WA 98362 2014-10-17
1528470861 Richard Dean Thorson Orthopaedic Surgery 719 S. Laurel St, Olympic Chiropractic, Port Angels, WA 98362 2014-05-21
1780001743 Dr Adam Cramer Pllc Clinic/Center 104 W. 3rd St, Port Angeles, WA 98362 2014-03-27
1588089189 Melanie Mccaughan Counselor 933 E First St, Port Angeles, WA 98362 2014-02-19
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Taxonomy Information

Taxonomy Code 314000000X
Grouping Nursing & Custodial Care Facilities
Classification Skilled Nursing Facility

Taxonomy Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417029885 Crestwood Convalescent - Port Angeles LLC Skilled Nursing Facility 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2006-11-14
1871006601 Crestwood Convalescent - Port Angeles LLC Skilled Nursing Facility 1116 E Lauridsen Blvd, Port Angeles, WA 98362-6640 2017-11-15

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1821639717 Atsugi LLC Skilled Nursing Facility 23815 Se 28th St, Sammamish, WA 98075 2019-10-02
1457840795 Mission Healthcare At Renton, LLC Skilled Nursing Facility 17420 106th Pl Se, Renton, WA 98055-5438 2018-05-02
1104330349 North Auburn Health, LLC Skilled Nursing Facility 2830 I Street Ne, Auburn, WA 98002 2017-11-27
1831603075 Fir Lane Health-shelton,llc Skilled Nursing Facility 2430 North 13th St, Shelton, WA 98584 2017-11-27
1851804959 Talbot Rehabilitation Center, LLC Skilled Nursing Facility 4430 Talbot Road South, Renton, WA 98055 2017-11-10
1215455365 Thirty Three Oaks, LLC Skilled Nursing Facility 400 E. 33rd St., Vancouver, WA 98663 2017-09-08
1730607953 Aurora Oaks, LLC Skilled Nursing Facility 16357 Aurora Avenue North, Shoreline, WA 98133 2017-09-08
1265950422 University Place Rehabilitation Center, LLC Skilled Nursing Facility 5520 Bridgeport Way W., University Place, WA 98467 2017-09-07
1235662081 Alexandra Vick Skilled Nursing Facility 18621 29th Ave E, Tacoma, WA 98445-4323 2017-04-08
1255883831 Heron's Key Skilled Nursing Facility 4340 Borgen Blvd, Gig Harbor, WA 98332-7000 2016-10-28
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Competitor

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City PORT ANGELES
Zip Code 98362

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Dataset Information

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.

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