MEDICARE: REKINDLE CLINIC 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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center

General Provider Information

NPI Number	:	1740131754
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REKINDLE CLINIC LLC

Provider Business Mailing Address
First Line	:	5333 15TH AVE S STE 1L
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-2866
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5333 15TH AVE S STE 1L
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98108-2866
Country	:	US
Telephone Number	:	424-567-1477
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	LEYLO AFRAH
Credential	:
Telephone Number	:	424-567-1477

Provider Enumeration Date	:	02/05/2026
Last Update Date	:	02/05/2026

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Directions to “REKINDLE CLINIC LLC ” Practice Location

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