LINDEN GROVE HEALTH CARE CENTER
NPI 1417959875
Skilled Nursing Facility in Puyallup, WA

Active since August 15, 2005CLIA 50D0892178 · Waiver
400 29TH STREET NE, PUYALLUP, WA 98372(253) 840-4400(253) 840-6733 Get Directions Write a Review

NPPES record last updated: May 19, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Linden Grove Health Care Center NPPES

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

LINDEN GROVE HEALTH CARE CENTER (NPI 1417959875) is a healthcare organization registered as a skilled nursing facility in Puyallup, Washington and active in the NPI registry since August 2005. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Carole M Scillia, Llc Manager, as its authorized official.

NPPES Registry Identity

NPI1417959875
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameREVERA (DELAWARE) LLC
Location Address400 29TH STREET NEPuyallup, WA 98372-6774
Mailing Address538 Preston Ave, Suite 270Meriden, CT 06450-4851 · (203) 608-6100 · Fax (203) 639-3574
Fax(253) 840-6733
Organization SubpartNo
Authorized OfficialCarole M ScilliaLlc Manager · (860) 347-6300
Enumeration DateAugust 15, 2005
Last NPPES UpdateMay 19, 2011
NPI 1417959875 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Licenses Licensed in WA · 1257 Licensed in WA · NH1257
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
400 29TH STREET NE, Puyallup, WA 98372

Other Names 1

Doing Business AsLinden Grove Health Care Center

Other Identifiers 3

Medicare OSCAR/certification505485WA
Medicare UPIN601868505
Medicaid4112579WA

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 50D0892178

Linden Grove Health Care Center · Puyallup, WA
Active · expires Apr 4, 2028
CLIA Number50D0892178
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateSeptember 26, 1994
Certificate Expiration DateApril 4, 2028
Laboratory DirectorSheila Mcdonough
Laboratory Phone(253) 840-4400
Laboratory LocationLinden Grove Health Care Center400 29th St NE, Puyallup, WA 98372
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Revera (delaware) LLC's NPI number?

The NPI number for Revera (delaware) LLC is 1417959875. It was assigned to this organization in the NPPES registry on August 15, 2005. The provider is doing business as Linden Grove Health Care Center.

Where is Revera (delaware) LLC located?

Revera (delaware) LLC is located at 400 29th Street NE, Puyallup, WA 98372. The listed phone number is (253) 840-4400.

What is Revera (delaware) LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Revera (delaware) LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D0892178) 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 Revera (delaware) LLC was last updated on May 19, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.