Organization
ENRICH ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BENARD CHESSUM RN, BSN (PROVIDER)
(612) 406-0088
Entity
Organization
Contact information
Practice address
14821 18TH AVE E, TACOMA, WA 98445-3477
(612) 406-0088
Mailing address
14821 18TH AVE E, TACOMA, WA 98445-3477
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
05/19/2023
Last updated
05/19/2023
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