Provider Demographics
NPI:1083146195
Name:US INNS ADULT FAMILY HOME INC
Entity Type:Organization
Organization Name:US INNS ADULT FAMILY HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/ PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TSEHAY
Authorized Official - Middle Name:MOBA
Authorized Official - Last Name:SEYOUM
Authorized Official - Suffix:
Authorized Official - Credentials:RN,BSN
Authorized Official - Phone:206-919-8722
Mailing Address - Street 1:16432 40TH PL W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-9023
Mailing Address - Country:US
Mailing Address - Phone:206-919-8722
Mailing Address - Fax:
Practice Address - Street 1:16432 40TH PL W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-9023
Practice Address - Country:US
Practice Address - Phone:206-919-8722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-29
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA163W00000X311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home