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ENRICH ADULT FAMILY HOME LLC NPI 1740971670


NPI Information

NPI: 1740971670
Provider Name: ENRICH ADULT FAMILY HOME LLC
Classification: Residential Treatment Facility, Intellectual and/or Developmental Disabilities - 320600000X
Entity Type: Organization

CLIA Number: 50D2296505

Address:
14821 18TH AVE E
TACOMA, WA
ZIP 98445
Phone: (612) 406-0088
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ENRICH ADULT FAMILY HOME LLC is a residential treatment facility, intellectual and/or developmental disabilities in Tacoma, WA. The provider is a residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently. ENRICH ADULT FAMILY HOME LLC NPI is 1740971670. The provider is registered as an organization entity type.

The provider's business location address is:

14821 18TH AVE E
TACOMA, WA
ZIP 98445-477
Phone: (612) 406-0088

The provider's authorized official is Benard Chessum .
The authorized official title is Provider and has the following contact phone number (612) 406-0088.

The CLIA number assigned to this NPI record is 50D2296505 - other - afh with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/19/2023 and was last updated on 5/19/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1320600000XResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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