NPIMap

Organization Active NPI

Kydd at Heart Adult Family Home LLC

  • Assisted Living Facility
  • Lacey, WA
National Provider Identifier
1275814121
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
752014 Issued in WA
Legal business name
KYDD AT HEART ADULT FAMILY HOME LLC
Practice address
4810 18TH Ave SE
Ste 2
Lacey, WA 98503-2652
Phone
(360) 790-2863
NPI assigned
Sep 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Authorized official

Name
Wendy Ann Kydd, CNA
Title
Provider
Phone
(360) 790-2863

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 752014 WA Primary
Respite Care 385H00000X 752014 WA

Addresses

Primary practice location

4810 18TH Ave SE
Ste 2
Lacey, WA 98503-2652

Mailing address

4810 18TH Ave SE
Ste 2
Lacey, WA 98503-2652
Phone (360) 790-2863

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1315267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315267200000",
    "number": "1275814121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4810 18TH AVE SE",
            "address_2": "STE 2",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985032652",
            "telephone_number": "360-790-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4810 18TH AVE SE",
            "address_2": "STE 2",
            "city": "LACEY",
            "state": "WA",
            "postal_code": "985032652",
            "telephone_number": "360-790-2863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYDD AT HEART ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-06",
        "last_updated": "2011-09-06",
        "status": "A",
        "authorized_official_last_name": "KYDD",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "360-790-2863",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "752014",
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "WA",
            "license": "752014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lacey, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2011; 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.