MEDICARE: SMOOTHCARE HOME LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235062118
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMOOTHCARE HOME LLC

Provider Business Mailing Address
First Line	:	8044 E D ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98404-1039
Country	:	US
Telephone Number	:	717-341-7274
Fax Number	:

Provider Business Practice Location Address
First Line	:	8044 E D ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98404-1039
Country	:	US
Telephone Number	:	717-341-7274
Fax Number	:

Authorized Official
Title or Position	:	PROVIDER/OWNER
Name	:	THATO ONALENNA MOLALE
Credential	:	CNA
Telephone Number	:	717-341-7274

Provider Enumeration Date	:	06/08/2026
Last Update Date	:	06/08/2026

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