Healthcare Provider Details

I. General information

NPI: 1306794045
Provider Name (Legal Business Name): HIDDEN GEM ADULT CARE HOME, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/18/2026
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19401 NE 249TH ST
BATTLE GROUND WA
98604-9688
US

IV. Provider business mailing address

19401 NE 249TH ST
BATTLE GROUND WA
98604-9688
US

V. Phone/Fax

Practice location:
  • Phone: 360-713-8202
  • Fax:
Mailing address:
  • Phone: 360-713-8202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ANNA MASSIE
Title or Position: OWNER OPERATOR
Credential: CNA
Phone: 360-713-8202