Provider Demographics
NPI:1386272664
Name:ENLIGHTENMENT HOME CARE LLC
Entity type:Organization
Organization Name:ENLIGHTENMENT HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONGAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:360-990-1092
Mailing Address - Street 1:809 LEGION WAY SE STE 305
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-1518
Mailing Address - Country:US
Mailing Address - Phone:360-339-5403
Mailing Address - Fax:360-515-0573
Practice Address - Street 1:809 LEGION WAY SE STE 305
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1518
Practice Address - Country:US
Practice Address - Phone:360-339-5403
Practice Address - Fax:360-515-0573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care