Provider Demographics
NPI:1922818343
Name:ELLIE'S CARING HAND ADULT FAMILY HOME LLC
Entity type:Organization
Organization Name:ELLIE'S CARING HAND ADULT FAMILY HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ENTITY REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:MEKLIT
Authorized Official - Middle Name:
Authorized Official - Last Name:MENCHA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:425-563-4139
Mailing Address - Street 1:15718 53RD PL W
Mailing Address - Street 2:
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98026-4739
Mailing Address - Country:US
Mailing Address - Phone:425-563-4139
Mailing Address - Fax:
Practice Address - Street 1:15718 53RD PL W
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-4739
Practice Address - Country:US
Practice Address - Phone:425-563-4139
Practice Address - Fax:425-740-0233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care