Organization Active NPI

Millcreek Afh, Inc

  • Adult Care Home Facility
  • Seattle, WA
National Provider Identifier
1114721727
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
Legal business name
MILLCREEK AFH, INC
Practice address
12024 Greenwood Ave N
Seattle, WA 98133-8130
Phone
(425) 750-5803
NPI assigned
Apr 2, 2025
Last updated
Apr 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jorge A FlorezNPI 1669276341
Title
Owner/Provider
Phone
(425) 750-5803

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X NU Primary

Addresses

Primary practice location

12024 Greenwood Ave N
Seattle, WA 98133-8130

Mailing address

16000 75TH PL W
Edmonds, WA 98026-4524
Phone (425) 750-5803

Other practice location 1

16703 36th Ave W
Lynnwood, WA 98037-7004
Phone (425) 750-5803

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
50D2277227Millcreek Afh Inc16703 36TH Ave W, Lynnwood, WA 98037Certificate of waiverApr 4, 2028
50D2303184Millcreek Afh, LLC12024 Greenwood Ave N, Seattle, WA 98133Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1743552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743552000000",
    "number": "1114721727",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16000 75TH PL W",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980264524",
            "telephone_number": "425-750-5803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12024 GREENWOOD AVE N",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981338130",
            "telephone_number": "425-750-5803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16703 36th Ave W",
            "address_purpose": "LOCATION",
            "city": "Lynnwood",
            "state": "WA",
            "postal_code": "980377004",
            "country_code": "US",
            "telephone_number": "425-750-5803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MILLCREEK AFH, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A",
        "authorized_official_last_name": "FLOREZ",
        "authorized_official_first_name": "JORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "425-750-5803"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.