Healthcare Provider Details

I. General information

NPI: 1922341304
Provider Name (Legal Business Name): ADULT DAY SERVICES OF THE TRI-CITIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 04/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 N WASHINGTON ST
KENNEWICK WA
99336-3859
US

IV. Provider business mailing address

10 N WASHINGTON ST
KENNEWICK WA
99336-3859
US

V. Phone/Fax

Practice location:
  • Phone: 509-586-5731
  • Fax: 509-586-5732
Mailing address:
  • Phone: 509-586-5731
  • Fax: 509-586-5732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number090459
License Number StateWA

VIII. Authorized Official

Name: REGINA ROMO
Title or Position: OFFICE ASSISTANT
Credential:
Phone: 509-586-5731