Provider Demographics
NPI:1720778491
Name:COUNCIL HOME CARE, INC.
Entity Type:Organization
Organization Name:COUNCIL HOME CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KERIANN
Authorized Official - Middle Name:
Authorized Official - Last Name:COUNCIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-705-1929
Mailing Address - Street 1:4325 LACEY BLVD SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-2352
Mailing Address - Country:US
Mailing Address - Phone:360-705-1929
Mailing Address - Fax:360-705-9248
Practice Address - Street 1:4325 LACEY BLVD SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-2352
Practice Address - Country:US
Practice Address - Phone:360-705-1929
Practice Address - Fax:360-705-9248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care