Healthcare Provider Details

I. General information

NPI: 1952847642
Provider Name (Legal Business Name): GOOD TO BE HOME CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2017
Last Update Date: 01/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8903 GRAVELLY LAKE DR SW
LAKEWOOD WA
98499-3149
US

IV. Provider business mailing address

8903 GRAVELLY LAKE DR SW
LAKEWOOD WA
98499-3149
US

V. Phone/Fax

Practice location:
  • Phone: 253-588-4344
  • Fax: 253-588-3033
Mailing address:
  • Phone: 253-588-4344
  • Fax: 253-588-3033

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: KIMBERLY DAVIS
Title or Position: EXECUTIVE ADMINISTRATOR
Credential:
Phone: 253-588-4344