Provider Demographics
NPI:1871125153
Name:ANDONIAN HOMECARE LLC
Entity type:Organization
Organization Name:ANDONIAN HOMECARE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CALEB
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDONIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-509-4814
Mailing Address - Street 1:10681 ECHO ROCK PL
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98332-5136
Mailing Address - Country:US
Mailing Address - Phone:253-509-4814
Mailing Address - Fax:503-641-4949
Practice Address - Street 1:10681 ECHO ROCK PL
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98332-5136
Practice Address - Country:US
Practice Address - Phone:253-509-4814
Practice Address - Fax:503-641-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-05
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite Care