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THE MOBILE TOOTH FAIRY P.S.

Ambulatory Health Care Facilities Clinic/Center Adult Day Care

Provider NPI: 1568803146

Organization Information:
Organization Name:  THE MOBILE TOOTH FAIRY P.S.
Organization is not Subpart
Authorized Official:  NICOLE LEE FINK  PRESIDENT/OWNER  253-444-7112

Practice Location:
6610 89TH STREET CT E  PUYALLUP, WA 98371-6222 US
Tel: 253-444-7112  Fax: --

Business Mailing Address:
6610 89TH STREET CT E  PUYALLUP, WA 98371-6222 US
Tel: 253-444-7112  Fax: --

NPI Information:
NPI: 1568803146
Entity Type: Organization

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N261QA0600XAmbulatory Health Care Facilities
Clinic/Center
Adult Day Care
N261QC1500XAmbulatory Health Care Facilities
Clinic/Center
N261QD0000XAmbulatory Health Care Facilities
Clinic/Center
N261QM0801XAmbulatory Health Care Facilities
Clinic/Center
N261QP0905XAmbulatory Health Care Facilities
Clinic/Center
N261QV0200XAmbulatory Health Care Facilities
Clinic/Center
N3104A0625XNursing & Custodial Care Facilities
Assisted Living Facility
N3104A0630XNursing & Custodial Care Facilities
Assisted Living Facility
N310500000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mental Illness
N311500000XNursing & Custodial Care Facilities
Alzheimer Center (Dementia Center)
N311ZA0620XNursing & Custodial Care Facilities
Custodial Care Facility
N313M00000XNursing & Custodial Care Facilities
Nursing Facility/Intermediate Care Facility
N314000000XNursing & Custodial Care Facilities
Skilled Nursing Facility
N315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
Y310400000XNursing & Custodial Care Facilities
Assisted Living Facility

Other Provider Identifiers:

IssuerNumberStateType
NPI1447592381WA01



American Medical Association 2012 taxonomy code information

Code: 310400000X

Type:

Classification:



Definition:



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