Provider Demographics
NPI:1790579621
Name:RICHMOND SENIOR CARE LLC
Entity type:Organization
Organization Name:RICHMOND SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:AJEMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-245-0972
Mailing Address - Street 1:200 NW 198TH ST
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98177-2548
Mailing Address - Country:US
Mailing Address - Phone:206-629-5023
Mailing Address - Fax:
Practice Address - Street 1:200 NW 198TH ST
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98177-2548
Practice Address - Country:US
Practice Address - Phone:206-629-5023
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home