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RESURRECTION ADULT FAMILY HOME LLC
NPI 1013629237
Home Health in Vancouver, WA

Active since December 19, 2022CLIA 50D2294161 · Waiver
10800 NE 109TH AVE, VANCOUVER, WA 98662(360) 258-0698 Get Directions Write a Review

NPPES record last updated: September 17, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 17, 2025, Dec 19, 2022 (2 updates tracked since 2022).

About Resurrection Adult Family Home Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RESURRECTION ADULT FAMILY HOME LLC (NPI 1013629237) is a healthcare organization registered as a home health in Vancouver, Washington and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through April 4, 2028, maintains 2 additional practice locations, and lists Abebe Gobeze, Director, as its authorized official.

NPPES Registry Identity

NPI1013629237
Entity TypeOrganization
Primary Taxonomy251E00000X
Legal Business NameRESURRECTION ADULT FAMILY HOME LLC
Location Address10800 NE 109TH AVEVancouver, WA 98662-3371
Mailing Address10800 Ne 109th AveVancouver, WA 98662-3371 · (360) 258-0698
Phone(360) 258-0698
Organization SubpartNo
Authorized OfficialAbebe GobezeDirector · (571) 665-9250
Enumeration DateDecember 19, 2022
Last NPPES UpdateSeptember 17, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 17, 2025
✔ NPI 1013629237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
10800 NE 109TH AVE, Vancouver, WA 98662
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Secondary Practice Locations 2

Location 110800 NE 109th AveVancouver, WA 98662-3371 · Phone (360) 258-0698
Location 214824 NE 81st StVancouver, WA 98682-3406 · Phone (360) 768-5494 · Fax (360) 768-5289

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2294161

Resurrection Adult Family Home LLC · Vancouver, WA
Active · expires Apr 4, 2028
CLIA Number50D2294161
Laboratory TypeAfh
Certificate Effective DateNovember 20, 2023
Certificate Expiration DateApril 4, 2028
Laboratory DirectorAbebe Gobeze
Laboratory Phone(360) 258-0698
Laboratory LocationResurrection Adult Family Home LLC10800 NE 109th Ave, Vancouver, WA 98662
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ABEBE MEBRATU GOBEZE LPN
Licensed Practical Nurse
10800 NE 109TH AVE
VANCOUVER, WA 98662
Clark County (571) 665-9250

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Resurrection Adult Family Home LLC's NPI number?

The NPI number for Resurrection Adult Family Home LLC is 1013629237. It was assigned to this organization in the NPPES registry on December 19, 2022.

Where is Resurrection Adult Family Home LLC located?

Resurrection Adult Family Home LLC is located at 10800 NE 109th Ave, Vancouver, WA 98662. The listed phone number is (360) 258-0698.

What is Resurrection Adult Family Home LLC's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

Does Resurrection Adult Family Home LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2294161) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Resurrection Adult Family Home LLC was last updated on September 17, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.