1. Home
  2. Directory
  3. Washington
  4. Spokane
  5. Assisted Living Facility
  6. NPI Profile

WILLOW GROVE, INC.
NPI 1073069514
Assisted Living Facility in Spokane, WA

Active since August 25, 2016CLIA 50D2248378 · Waiver
1620 E MEAD ST, SPOKANE, WA 99218(509) 467-1135(509) 468-7906 Get Directions Write a Review

NPPES record last updated: August 25, 2016. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Willow Grove, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLOW GROVE, INC. (NPI 1073069514) is a healthcare organization registered as an assisted living facility in Spokane, Washington and active in the NPI registry since August 2016. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Leroy Gilbert Mattson, Ceo, President, as its authorized official.

NPPES Registry Identity

NPI1073069514
Entity TypeOrganization
Primary Taxonomy310400000X
Legal Business NameWILLOW GROVE, INC.
Location Address1620 E MEAD STSpokane, WA 99218-1772
Mailing Address1620 E Mead StSpokane, WA 99218-1772 · (509) 467-1135 · Fax (509) 468-7906
Phone(509) 467-1135
Fax(509) 468-7906
Organization SubpartNo
Authorized OfficialLeroy Gilbert MattsonCeo, President · 50946711135
Enumeration DateAugust 25, 2016
✔ NPI 1073069514 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities
Taxonomy Code310400000X
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
1620 E MEAD ST, Spokane, WA 99218
Open in Google Maps ↗

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2248378

Willow Grove Assisted Living · Spokane, WA
Active · expires Apr 4, 2028
CLIA Number50D2248378
Laboratory TypeAssisted Living Facility
Certificate Effective DateOctober 4, 2024
Certificate Expiration DateApril 4, 2028
Laboratory DirectorCori Hazard
Laboratory Phone(509) 467-1135
Laboratory LocationWillow Grove Assisted Living1620 E Mead St, Spokane, WA 99218
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LEGACY1864, LLC
Assisted Living Facility
1620 E MEAD ST
SPOKANE, WA 99218
Spokane County (509) 467-1135

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willow Grove, Inc.'s NPI number?

The NPI number for Willow Grove, Inc. is 1073069514. It was assigned to this organization in the NPPES registry on August 25, 2016.

Where is Willow Grove, Inc. located?

Willow Grove, Inc. is located at 1620 E Mead St, Spokane, WA 99218. The listed phone number is (509) 467-1135.

What is Willow Grove, Inc.'s specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Does Willow Grove, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2248378) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Willow Grove, Inc. was last updated on August 25, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.