Candleberry Adult Family Home LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

CANDLEBERRY ADULT FAMILY HOME LLC

Practice address

7518 56TH PL NE
Marysville, WA 98270-9203

Phone

(425) 583-0521

Fax

(360) 322-6619

NPI assigned

Nov 18, 2024

Organization subpart

No

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

Authorized official

Name

J Billington W Mwangi

Title

Provider

Phone

(425) 583-0521

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1184449944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7518 56TH PL NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982709203",
            "telephone_number": "425-583-0521",
            "fax_number": "360-322-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7518 56TH PL NE",
            "city": "MARYSVILLE",
            "state": "WA",
            "postal_code": "982709203",
            "telephone_number": "425-583-0521",
            "fax_number": "360-322-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANDLEBERRY ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "MWANGI",
        "authorized_official_first_name": "J BILLINGTON",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "425-583-0521"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Marysville, WA
• Providers in Marysville, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.