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General NPI Number Information
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NPI Number | 1376265306
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Entity Type | Organization
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Legal Business Name | RESIDENCE CHOICE ADULT FAMILY HOME
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 17400 17TH PL NE
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City | SHORELINE
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State | WA
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Zip | 98155-5202
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Country | US
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Telephone | 302-357-5104
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Fax | 425-200-6172
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Provider Business Mailing Address
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Address Line | 17400 17TH PL NE
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City | SHORELINE
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State | WA
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Zip | 98155-5202
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Country | US
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Telephone | 302-357-5104
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | JAMES MWANGI
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Credential |
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Telephone | 302-357-5104
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 315D00000X
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Taxonomy Name | Inpatient Hospice
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 376G00000X
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Taxonomy Name | Nursing Home Administrator
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #10
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number |
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License Number State |
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