Organization
AT HOME RESIDENTIAL ESF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES KENNEDY (CHIEF FINANCIAL OFFICER)
(509) 263-4314
Entity
Organization
Contact information
Practice address
4040 26TH AVE SW APT 501, SEATTLE, WA 98106-1295
(509) 263-4314
Mailing address
1007 MOYER ST, CHENEY, WA 99004-1357
(509) 263-4314
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
—
—
Other
Enumeration date
11/28/2022
Last updated
11/28/2022
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