Provider Demographics
NPI:1366223307
Name:JOSEPHINE CARING COMMUNITY
Entity type:Organization
Organization Name:JOSEPHINE CARING COMMUNITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-629-2126
Mailing Address - Street 1:9901 272ND PL NW
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-7449
Mailing Address - Country:US
Mailing Address - Phone:360-386-3284
Mailing Address - Fax:360-999-5645
Practice Address - Street 1:9901 272ND PL NW
Practice Address - Street 2:
Practice Address - City:STANWOOD
Practice Address - State:WA
Practice Address - Zip Code:98292-7449
Practice Address - Country:US
Practice Address - Phone:360-386-3284
Practice Address - Fax:360-999-5645
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOSEPHINE CARING COMMUNITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health