Provider Demographics
NPI:1306289921
Name:SSP CARE SERVICES, LLC
Entity type:Organization
Organization Name:SSP CARE SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SYLVIANE
Authorized Official - Middle Name:G
Authorized Official - Last Name:POTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-638-3153
Mailing Address - Street 1:27661 188TH PL SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98042-5440
Mailing Address - Country:US
Mailing Address - Phone:253-638-3153
Mailing Address - Fax:253-590-2883
Practice Address - Street 1:10900 NE 4TH ST
Practice Address - Street 2:SUITE 2300
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-5873
Practice Address - Country:US
Practice Address - Phone:206-484-3144
Practice Address - Fax:253-590-2883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-12
Last Update Date:2013-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAIHS.FS.60221570333300000X, 347C00000X, 251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No333300000XSuppliersEmergency Response System Companies
No347C00000XTransportation ServicesPrivate Vehicle
No251E00000XAgenciesHome Health