=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881527786
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GOD'S IMMENSE CARE FOUNDATION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/08/2026
-----------------------------------------------------
Last Update Date | 06/08/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4917 HENLEY ST
-----------------------------------------------------
City | BLAINE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98230-9610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-754-0595
-----------------------------------------------------
Fax | 360-746-7967
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4917 HENLEY ST
-----------------------------------------------------
City | BLAINE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98230-9610
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 360-754-0595
-----------------------------------------------------
Fax | 360-746-7967
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PROVIDER
-----------------------------------------------------
Name | FAMOUS APPLEWHITE
-----------------------------------------------------
Credential | CNA
-----------------------------------------------------
Telephone | 346-754-0595
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 311ZA0620X
-----------------------------------------------------
Taxonomy Name | Adult Care Home Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------