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General NPI Number Information
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NPI Number | 1902726599
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Entity Type | Organization
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Legal Business Name | SENIOR VILLAGE ADULT FAMILY HOME LLC
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 931 177TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98008-3408
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Country | US
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Telephone | 425-625-1604
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Fax | 425-590-9881
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Provider Business Mailing Address
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Address Line | 931 177TH AVE NE
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City | BELLEVUE
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State | WA
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Zip | 98008-3408
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Country | US
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Telephone | 425-625-1604
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Fax | 425-590-9881
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Authorized Official
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Title or Position | PROVIDER/ADMINISTRATOR
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Name | MISS BOBBETTE KERR
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Credential | CNA
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Telephone | 425-625-1604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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License Number |
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License Number State |
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