Healthcare Provider Details

I. General information

NPI: 1740607936
Provider Name (Legal Business Name): PERSONAL BEST SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2014
Last Update Date: 04/09/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29222 54TH PL S
AUBURN WA
98001-2157
US

IV. Provider business mailing address

29222 54TH PL S P.O. BOX 1976
AUBURN WA
98001-2157
US

V. Phone/Fax

Practice location:
  • Phone: 253-946-5700
  • Fax: 253-397-3448
Mailing address:
  • Phone: 253-946-5700
  • Fax: 253-397-3448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberNPOL.NR.60464158
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License NumberIHSFS60458786
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License NumberUBI603236079
License Number StateWA

VIII. Authorized Official

Name: WILLIAM LOUIS KENDRICK
Title or Position: CHIEF FINANCIAL OFFICER
Credential: AIPS
Phone: 253-946-5700