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General NPI Number Information
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NPI Number | 1033509252
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Entity Type | Organization
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Legal Business Name | MARTHA & MARY HOME AND COMMUNITY SERVICES
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Dates
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Enumeration Date | 01/26/2015
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Last Update Date | 01/26/2015
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Provider Practice Location Address
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Address Line | 19160 FRONT STREET NE
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City | POULSBO
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State | WA
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Zip | 98370-0127
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Country | US
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Telephone | 360-779-7500
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 127
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City | POULSBO
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State | WA
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Zip | 98370-0127
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Country | US
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Telephone | 360-779-7500
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. CHAD MICHAEL SOLVIE
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Credential |
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Telephone | 360-779-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 60123737
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 60123737
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 60123737
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License Number State | WA
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