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Organization
WEEPING RIDGE ESTATE ADULT FAMILY HOME INC
Active
Organization
WEEPING RIDGE ESTATE ADULT FAMILY HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ISRAEL RODRIGUEZ (ADMINISTRATOR)
(509) 989-1843
Entity
Organization
Contact information
Practice address
2455 W. BENCH RD, OTHELLO, WA 99344
(509) 989-1843
(509) 465-1813
Mailing address
12402 OSPREY RD, NINE MILE FALLS, WA 99026
(509) 989-1843
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
378700
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
270753
ADULT FAMILY HOME
WA
Enumeration date
11/03/2014
Last updated
11/03/2014
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