- Enrollment id
- O20150828001794
- Enrollment state
- WA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1225414212
- Multiple npi flag
- N
- Ccn
- 505526
- Associate id
- 0244546752
- Organization name
- SOUTH HILL OPERATIONS LLC
- Doing business as name
- LIFE CARE CENTER OF SOUTH HILL
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- LIFE CARE CENTER OF SOUTH HILL
- Affiliation entity name
- LIFE CARE CENTERS OF AMERICA
- Affiliation entity id
- 311
- Address line 1
- 2508 7TH ST SE
- City
- PUYALLUP
- State
- WA
- Zip code
- 983741105