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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