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General NPI Number Information
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NPI Number | 1427743343
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Entity Type | Organization
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Legal Business Name | NEWCASTLE ADULT FAMILY HOME LLC
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Dates
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Enumeration Date | 04/06/2023
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Last Update Date | 04/06/2023
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Provider Practice Location Address
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Address Line | 6583 125TH AVE SE
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City | BELLEVUE
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State | WA
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Zip | 98006-3936
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Country | US
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Telephone | 206-412-0578
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Fax |
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Provider Business Mailing Address
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Address Line | 6583 125TH AVE SE
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City | BELLEVUE
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State | WA
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Zip | 98006-3936
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Country | US
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Telephone | 206-412-0578
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | BERHANU ALEMU GURUMU
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Credential |
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Telephone | 206-412-0578
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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