Provider Demographics
NPI:1043810534
Name:APPLE CREEK, INC.
Entity type:Organization
Organization Name:APPLE CREEK, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SONYA
Authorized Official - Middle Name:JASMINE
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:MA, HCA
Authorized Official - Phone:509-895-5623
Mailing Address - Street 1:513 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98903-1308
Mailing Address - Country:US
Mailing Address - Phone:509-895-5623
Mailing Address - Fax:509-207-7423
Practice Address - Street 1:513 W WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98903-1308
Practice Address - Country:US
Practice Address - Phone:509-895-5623
Practice Address - Fax:509-207-7423
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-26
Last Update Date:2020-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home