Provider Demographics
NPI:1841174653
Name:MANNA ADULT FAMILY HOME
Entity type:Organization
Organization Name:MANNA ADULT FAMILY HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:YENENESH
Authorized Official - Middle Name:TSEGAY
Authorized Official - Last Name:WORKNEH
Authorized Official - Suffix:
Authorized Official - Credentials:RN61324907
Authorized Official - Phone:702-292-8464
Mailing Address - Street 1:6220 EAST DR
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-4411
Mailing Address - Country:US
Mailing Address - Phone:702-336-1576
Mailing Address - Fax:
Practice Address - Street 1:6220 EAST DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-4411
Practice Address - Country:US
Practice Address - Phone:702-336-1576
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-04
Last Update Date:2025-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home