Provider Demographics
NPI:1437942810
Name:MELODY 24 HOUR RESIDENTIAL HOME LLC
Entity type:Organization
Organization Name:MELODY 24 HOUR RESIDENTIAL HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SEGNI
Authorized Official - Middle Name:ABRAHAM
Authorized Official - Last Name:DIBISSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-885-9678
Mailing Address - Street 1:1313 SW 209TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALOHA
Mailing Address - State:OR
Mailing Address - Zip Code:97003-2593
Mailing Address - Country:US
Mailing Address - Phone:240-885-9678
Mailing Address - Fax:
Practice Address - Street 1:1313 SW 209TH AVE
Practice Address - Street 2:
Practice Address - City:ALOHA
Practice Address - State:OR
Practice Address - Zip Code:97003-2593
Practice Address - Country:US
Practice Address - Phone:240-885-9678
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-27
Last Update Date:2025-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities