Provider Demographics
NPI:1780070599
Name:HOME INSTEAD SENIOR CARE
Entity type:Organization
Organization Name:HOME INSTEAD SENIOR CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:KENNETH
Authorized Official - Last Name:LOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-622-4663
Mailing Address - Street 1:3221 EASTLAKE AVE E
Mailing Address - Street 2:SUITE #120
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-7125
Mailing Address - Country:US
Mailing Address - Phone:206-622-4663
Mailing Address - Fax:206-223-8544
Practice Address - Street 1:3221 EASTLAKE AVE E
Practice Address - Street 2:SUITE #120
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-7125
Practice Address - Country:US
Practice Address - Phone:206-622-4663
Practice Address - Fax:206-223-8544
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-08
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARCW 70.127253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care