Provider Demographics
NPI:1245642636
Name:BANDA ENTERPRISES LLC.
Entity type:Organization
Organization Name:BANDA ENTERPRISES LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-742-3773
Mailing Address - Street 1:2958 LIMITED LN NW
Mailing Address - Street 2:SUITE B
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4577
Mailing Address - Country:US
Mailing Address - Phone:360-742-3773
Mailing Address - Fax:
Practice Address - Street 1:2958 LIMITED LN NW
Practice Address - Street 2:SUITE B
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4577
Practice Address - Country:US
Practice Address - Phone:360-742-3773
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-20
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIHS.FS.60453361253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care