A Maje Manor Adult Family Home LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

A MAJE MANOR ADULT FAMILY HOME LLC

Doing business as

A Maje Manor Adult Family Home llc

Practice address

16608 NE 19TH PL
Bellevue, WA 98008-2686

Phone

(425) 586-0255

Fax

(425) 746-8072

NPI assigned

Aug 25, 2023

Last updated

Aug 25, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Glenn J Boctot, MR

Title

Provider

Phone

(425) 586-0255

Specialties & licenses 1

Addresses

Other names 1

• A Maje Manor Adult Family Home llc Doing business as

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

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1124803481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12912 SE 186TH ST",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980587981",
            "telephone_number": "425-586-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16608 NE 19TH PL",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980082686",
            "telephone_number": "425-586-0255",
            "fax_number": "425-746-8072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A MAJE MANOR ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "BOCTOT",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "425-586-0255",
        "authorized_official_credential": "MR"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "A Maje Manor Adult Family Home llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.