Healthcare Provider Details

I. General information

NPI: 1154566768
Provider Name (Legal Business Name): ACREN HEALTH CARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 03/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 142ND PLACE SW
LYNNWOOD WA
98087-6407
US

IV. Provider business mailing address

P.O. BOX 65161
SHORELINE WA
98155
US

V. Phone/Fax

Practice location:
  • Phone: 425-778-9102
  • Fax:
Mailing address:
  • Phone: 425-778-9102
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171R00000X
TaxonomyInterpreter
License NumberPMA2319
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNPOL NR 00000586
License Number StateWA
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberNPOL.NR.00000586
License Number StateWA
# 4
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberNPOL NR 0000586
License Number StateWA
# 5
Primary TaxonomyY
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberNR00000586
License Number StateWA

VIII. Authorized Official

Name: JAMAL SOBKA
Title or Position: CEO
Credential:
Phone: 425-778-9102