Provider Demographics
NPI: | 1700227832 |
---|---|
Name: | BEST HEALTH FAMILY HOME |
Entity Type: | Organization |
Organization Name: | BEST HEALTH FAMILY HOME |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | REGISTERED NURSE |
Authorized Official - Prefix: | |
Authorized Official - First Name: | HAZELINE |
Authorized Official - Middle Name: | VILLARUZ |
Authorized Official - Last Name: | GUMIRAN-ALEJANDRO |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 206-372-2960 |
Mailing Address - Street 1: | 714 S 38TH CT |
Mailing Address - Street 2: | |
Mailing Address - City: | RENTON |
Mailing Address - State: | WA |
Mailing Address - Zip Code: | 98055-5894 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 425-227-7139 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 17403 SE 196TH DR |
Practice Address - Street 2: | 6625 112 SE |
Practice Address - City: | RENTON |
Practice Address - State: | WA |
Practice Address - Zip Code: | 98058-9624 |
Practice Address - Country: | US |
Practice Address - Phone: | 425-255-2111 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-07-17 |
Last Update Date: | 2013-07-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WA | 707700 | 311ZA0620X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 311ZA0620X | Nursing & Custodial Care Facilities | Custodial Care Facility | Adult Care Home |