- Enrollment id
- O20230120000681
- Enrollment state
- WA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1366154791
- Multiple npi flag
- N
- Ccn
- 505009
- Associate id
- 4284005703
- Organization name
- SHORELINE OPERATIONS LLC
- Doing business as name
- AVAMERE REHABILITATION OF SHORELINE
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- AVAMERE REHABILITATION OF SHORELINE
- Affiliation entity name
- AVAMERE
- Affiliation entity id
- 58
- Address line 1
- 1250 NE 145TH ST
- City
- SHORELINE
- State
- WA
- Zip code
- 981557134