Elder Village Renton Highlands Afh, LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

ELDER VILLAGE RENTON HIGHLANDS AFH, LLC

Practice address

603 Nile Ave NE
Renton, WA 98059-4980

Phone

(206) 886-1611

NPI assigned

Feb 9, 2024

Organization subpart

No

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

Authorized official

Name

Bernice Rebutiaco, ARNP

Title

Administrator

Phone

(206) 653-6477

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Elder Village Renton Highlands AFH Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763683200000",
    "number": "1851155907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 NILE AVE NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594980",
            "telephone_number": "206-653-6477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 NILE AVE NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980594980",
            "telephone_number": "206-886-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDER VILLAGE RENTON HIGHLANDS AFH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-09",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A",
        "authorized_official_last_name": "REBUTIACO",
        "authorized_official_first_name": "BERNICE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "206-653-6477",
        "authorized_official_credential": "ARNP"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1477166031",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elder Village Renton Highlands AFH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Eickelmann, PA-C
• Nicole Hanson Eisenhut, OTD, OTR/L
• Megan Marie Eitel, M.D.
• Elaine Arnold LM CPM
• Messeret Elala, RN
• Christopher Apolonio Eleccion
• Elevated Medical Homes PLLC
• Samantha Eller, M.D.
• Gail Ann Elliott, PHARMD
• Ellison Terrace Afh LLC

• Adult Care Home Facility in Renton, WA
• Providers in Renton, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.