Infinite Grace Adult Family Home LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

INFINITE GRACE ADULT FAMILY HOME LLC

Practice address

6113 188TH St SW
Lynnwood, WA 98037-7247

Phone

(425) 327-2690

NPI assigned

Oct 9, 2024

Organization subpart

No

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

Authorized official

Name

Joseph Gan

Title

Provider

Phone

(425) 327-2690

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1728432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733529600000",
    "number": "1508685173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8120 HARDESON RD UNIT 4158",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982040109",
            "telephone_number": "425-327-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6113 188TH ST SW",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980377247",
            "telephone_number": "425-327-2690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITE GRACE ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-09",
        "last_updated": "2024-12-07",
        "certification_date": "2024-12-07",
        "status": "A",
        "authorized_official_last_name": "GAN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "425-327-2690"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• In Home Supportive Care Agency in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• In Home Supportive Care Agency in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.