- Enrollment id
- O20140502000003
- Enrollment state
- WA
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1407271430
- Multiple npi flag
- N
- Ccn
- 505304
- Associate id
- 7214160043
- Organization name
- WILDWOOD HEALTHCARE INC.
- Doing business as name
- RAINIER REHABILITATION
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Nursing home provider name
- RAINIER REHABILITATION
- Affiliation entity name
- THE ENSIGN GROUP
- Affiliation entity id
- 507
- Address line 1
- 920 12TH AVE SE
- City
- PUYALLUP
- State
- WA
- Zip code
- 983724920