Provider Demographics
NPI:1720221716
Name:AMENITY HOME HEALTH CARE, INC
Entity Type:Organization
Organization Name:AMENITY HOME HEALTH CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MARKDAVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:OBENZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-919-2471
Mailing Address - Street 1:6305 NE 187TH ST
Mailing Address - Street 2:
Mailing Address - City:KENMORE
Mailing Address - State:WA
Mailing Address - Zip Code:98028-8925
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6305 NE 187TH ST
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:WA
Practice Address - Zip Code:98028-8925
Practice Address - Country:US
Practice Address - Phone:206-368-3820
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-07
Last Update Date:2011-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA15213251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health