Provider Demographics
NPI:1912887423
Name:EMERALD CITY ESF II LLC
Entity type:Organization
Organization Name:EMERALD CITY ESF II LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BORAY
Authorized Official - Middle Name:
Authorized Official - Last Name:THACH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, PMHNP-BC
Authorized Official - Phone:253-230-6912
Mailing Address - Street 1:3711 PACIFIC AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98418-7827
Mailing Address - Country:US
Mailing Address - Phone:253-230-6912
Mailing Address - Fax:
Practice Address - Street 1:3711 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98418-7827
Practice Address - Country:US
Practice Address - Phone:253-230-6912
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility