Provider Demographics
NPI:1629882287
Name:EPIPHANY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:EPIPHANY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADJARATOU
Authorized Official - Middle Name:
Authorized Official - Last Name:KATEMBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-834-5671
Mailing Address - Street 1:3407 MEADOW AVE N
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-1920
Mailing Address - Country:US
Mailing Address - Phone:425-545-9844
Mailing Address - Fax:425-988-3161
Practice Address - Street 1:3407 MEADOW AVE N
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98056-1920
Practice Address - Country:US
Practice Address - Phone:425-545-9844
Practice Address - Fax:425-988-3161
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care