Organization
PLYMOUTH HOUSING GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLI LARSEN (CHIEF PROGRAM OFFICER)
(206) 374-9409
Entity
Organization
Contact information
Practice address
2113 3RD AVE, SEATTLE, WA 98121-2321
(206) 374-9409
Mailing address
2113 3RD AVE, SEATTLE, WA 98121-2321
(206) 374-9409
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
09/06/2018
Last updated
12/02/2019
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