Healthcare Provider Details

I. General information

NPI: 1801912373
Provider Name (Legal Business Name): COMMUNITY HOME CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7136 MARTIN LUTHER KING JR WAY S STE 201
SEATTLE WA
98118-3526
US

IV. Provider business mailing address

7136 MARTIN LUTHER KING JR WAY S STE 201
SEATTLE WA
98118-3526
US

V. Phone/Fax

Practice location:
  • Phone: 206-384-4539
  • Fax:
Mailing address:
  • Phone: 206-384-4539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License NumberIS145
License Number StateWA

VIII. Authorized Official

Name: MR. ABDURAHMAN WARSAMA JAMA
Title or Position: OWNER
Credential: ADMINISTRATOR
Phone: 206-384-4539