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General NPI Number Information
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NPI Number | 1386272664
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Entity Type | Organization
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Legal Business Name | ENLIGHTENMENT HOME CARE LLC
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Dates
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Enumeration Date | 03/31/2020
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Last Update Date | 02/07/2023
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Provider Practice Location Address
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Address Line | 809 LEGION WAY SE STE 305
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City | OLYMPIA
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State | WA
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Zip | 98501-1518
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Country | US
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Telephone | 360-339-5403
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Fax | 360-515-0573
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Provider Business Mailing Address
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Address Line | 809 LEGION WAY SE STE 305
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City | OLYMPIA
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State | WA
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Zip | 98501-1518
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Country | US
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Telephone | 360-339-5403
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Fax | 360-515-0573
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SONGAYA GAY
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Credential | LPN
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Telephone | 360-990-1092
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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