Healthcare Provider Details

I. General information

NPI: 1518892165
Provider Name (Legal Business Name): BLUE SAGE ADULT FAMILY HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5006 BLUE SAGE DR
PASCO WA
99301-4015
US

IV. Provider business mailing address

5006 BLUE SAGE DR
PASCO WA
99301-4015
US

V. Phone/Fax

Practice location:
  • Phone: 509-572-8984
  • Fax: 509-219-3500
Mailing address:
  • Phone: 509-572-8984
  • Fax: 509-219-3500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: ADWOA YEBOAH
Title or Position: OWNER
Credential:
Phone: 509-572-8984