Organization
PROACTIVE HOME CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC WILLIAM KELLY (OWNER AND CEO)
(206) 926-9551
Entity
Organization
Contact information
Practice address
3121 E MADISON ST STE 203B, SEATTLE, WA 98112-4258
(206) 926-9551
(206) 260-7256
Mailing address
3121 E MADISON ST STE 203B, SEATTLE, WA 98112-4258
(206) 926-9551
(206) 260-7256
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528594082
—
MO
Enumeration date
02/22/2018
Last updated
04/10/2019
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