Provider Demographics
NPI:1902614852
Name:ARIAM GOLDEN CARE ADULT FAMILY HOME LLC
Entity type:Organization
Organization Name:ARIAM GOLDEN CARE ADULT FAMILY HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MR
Authorized Official - First Name:DAWIT
Authorized Official - Middle Name:
Authorized Official - Last Name:GEBREZGHI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:206-407-9641
Mailing Address - Street 1:5801 224TH PL SW
Mailing Address - Street 2:
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-3725
Mailing Address - Country:US
Mailing Address - Phone:206-407-9641
Mailing Address - Fax:
Practice Address - Street 1:5801 224TH PL SW
Practice Address - Street 2:
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-3725
Practice Address - Country:US
Practice Address - Phone:206-407-9641
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-24
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care