Provider Demographics
NPI:1639955768
Name:SIX STAR ELDER CARE LLC
Entity Type:Organization
Organization Name:SIX STAR ELDER CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-351-3464
Mailing Address - Street 1:31408 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-5302
Mailing Address - Country:US
Mailing Address - Phone:206-351-3464
Mailing Address - Fax:206-429-2217
Practice Address - Street 1:31801 8TH AVE S
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-5324
Practice Address - Country:US
Practice Address - Phone:206-351-3464
Practice Address - Fax:206-429-2217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home