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General NPI Number Information
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NPI Number | 1215463112
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Entity Type | Organization
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Legal Business Name | SUNUP HOME CARE
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 524 227TH LN NE
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City | SAMMAMISH
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State | WA
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Zip | 98074-7141
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Country | US
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Telephone | 425-998-7942
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Fax |
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Provider Business Mailing Address
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Address Line | 524 227TH LN NE
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City | SAMMAMISH
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State | WA
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Zip | 98074-7141
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Country | US
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Telephone | 425-591-5275
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CHIJIOKE EKEKE
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Credential |
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Telephone | 425-591-5275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | IHS.FS.60728313
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License Number State | WA
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