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General NPI Number Information
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NPI Number | 1114411691
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Entity Type | Organization
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Legal Business Name | GASSELING HOUSE ADF
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Dates
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Enumeration Date | 06/19/2018
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Last Update Date | 06/19/2018
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Provider Practice Location Address
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Address Line | 905 BEAUDRY RD
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City | YAKIMA
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State | WA
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Zip | 98901-8104
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Country | US
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Telephone | 509-248-8584
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Fax | 509-577-8525
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Provider Business Mailing Address
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Address Line | 905 BEAUDRY RD
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City | YAKIMA
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State | WA
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Zip | 98901-8104
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Country | US
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Telephone | 509-248-8584
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Fax | 509-577-8525
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Authorized Official
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Title or Position | OWNER
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Name | ALLEN JOE GASSELING
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Credential | AFH
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Telephone | 509-248-8584
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 252400
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License Number State | WA
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