Provider Demographics
NPI:1174386718
Name:SALAAM RESIDENTIAL CARE LLC
Entity type:Organization
Organization Name:SALAAM RESIDENTIAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMUD
Authorized Official - Middle Name:
Authorized Official - Last Name:WARSAME
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-477-9310
Mailing Address - Street 1:27020 PACIFIC HWY S STE A
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-6951
Mailing Address - Country:US
Mailing Address - Phone:425-477-9310
Mailing Address - Fax:
Practice Address - Street 1:6329 S 212TH ST APT H103
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-2496
Practice Address - Country:US
Practice Address - Phone:206-960-1764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251B00000XAgenciesCase ManagementGroup - Multi-Specialty