Provider Demographics
NPI:1144814401
Name:NEYAT ADULT FAMILY HOME LLC
Entity type:Organization
Organization Name:NEYAT ADULT FAMILY HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:G
Authorized Official - Last Name:MEZENGIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-596-6742
Mailing Address - Street 1:12402 E 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0323
Mailing Address - Country:US
Mailing Address - Phone:509-904-9609
Mailing Address - Fax:
Practice Address - Street 1:12402 E 19TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0323
Practice Address - Country:US
Practice Address - Phone:509-822-7593
Practice Address - Fax:509-822-7895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty