Provider Demographics
NPI:1922341304
Name:ADULT DAY SERVICES OF THE TRI-CITIES
Entity Type:Organization
Organization Name:ADULT DAY SERVICES OF THE TRI-CITIES
Other - Org Name:BENTON FRANKLIN ELDER SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:REGINA
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-586-5731
Mailing Address - Street 1:10 N WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-3859
Mailing Address - Country:US
Mailing Address - Phone:509-586-5731
Mailing Address - Fax:509-586-5732
Practice Address - Street 1:10 N WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-3859
Practice Address - Country:US
Practice Address - Phone:509-586-5731
Practice Address - Fax:509-586-5732
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-03
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA090459261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA809862Medicaid