Provider Demographics
NPI:1487106456
Name:SERENGETI CARE PARTNERS LLC
Entity type:Organization
Organization Name:SERENGETI CARE PARTNERS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNANGA
Authorized Official - Suffix:
Authorized Official - Credentials:DBH
Authorized Official - Phone:206-552-5472
Mailing Address - Street 1:707 S GRADY WAY
Mailing Address - Street 2:SUITE 6008
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-3224
Mailing Address - Country:US
Mailing Address - Phone:206-552-5472
Mailing Address - Fax:425-207-7401
Practice Address - Street 1:707 S- GRADY WAY, SUITE 6008
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057
Practice Address - Country:US
Practice Address - Phone:206-552-5472
Practice Address - Fax:425-207-7401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-26
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAS.FS.60660148251S00000X
WAIHS.FS.60660148253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care