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General NPI Number Information
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NPI Number | 1629713623
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Entity Type | Organization
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Legal Business Name | DENALI CARE SERVICES, LLC.
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Dates
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Enumeration Date | 05/03/2022
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Last Update Date | 05/03/2022
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Provider Practice Location Address
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Address Line | 31620 23RD AVE S # 302
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City | FEDERAL WAY
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State | WA
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Zip | 98003-5064
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Country | US
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Telephone | 206-592-2756
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Fax | 206-238-9450
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Provider Business Mailing Address
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Address Line | 31620 23RD AVE S # 302
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City | FEDERAL WAY
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State | WA
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Zip | 98003-5064
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Country | US
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Telephone | 206-592-2756
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Fax | 206-238-9450
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Authorized Official
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Title or Position | CO-OWNER
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Name | ENI IERUSALEMA MAVAEGA
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Credential |
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Telephone | 907-297-8942
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training 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 | 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 #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health 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 | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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