A Maje Manor Adult Family Home LLC
In Home Supportive Care in Bellevue, WA. Organization (NPI-2).
NPI number1124803481
StatusActive
Last updated in NPPESAug 25, 2023
Details
- NPI
- 1124803481
- Entity type
- Organization (NPI-2)
- Legal business name
- A Maje Manor Adult Family Home LLC
- Organization subpart
- No
- Enumeration date
- Aug 25, 2023
- Certification date
- Aug 25, 2023
- Last updated
- Aug 25, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 253Z00000X | In Home Supportive Care | – | – | Yes |
Other names
- A Maje Manor Adult Family Home LLC (Doing Business As)
Practice location
16608 Ne 19th PlBellevue, WA 98008-2686
Phone 425-586-0255 · Fax 425-746-8072
Mailing address
12912 Se 186th StRenton, WA 98058-7981
Phone 425-586-0255
Authorized official
Glenn J Boctot
Provider
4255860255
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