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

NPI Status: Active since December 19, 2022

Contact Information

10800 NE 109TH AVE
VANCOUVER, WA
ZIP 98662
Phone: (360) 258-0698

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  • Organization
  • Home Health
  • CLIA Number: 50D2294161
  • CLIA Cert. Type: Other - AFH
  • CLIA Exp. Date: 04-04-2028

About RESURRECTION ADULT FAMILY HOME LLC

This page provides the complete NPI Profile along with additional information for Resurrection Adult Family Home Llc, a provider established in Vancouver, Washington operating as a Home Health. The healthcare provider is registered in the NPI registry with number 1013629237 assigned on December 2022. The practitioner's primary taxonomy code is 251E00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The authorized official of this NPI record is Abebe Gobeze (Director)

NPI
1013629237
Provider Name
RESURRECTION ADULT FAMILY HOME LLC
Entity Type
Organization
Location Address
10800 NE 109TH AVE VANCOUVER, WA 98662
Location Phone
(360) 258-0698
Mailing Address
10800 NE 109TH AVE VANCOUVER, WA 98662
Mailing Phone
(360) 258-0698
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
12-19-2022
Last Update Date
09-17-2025
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Location Map

Secondary Locations

  • 14824 NE 81st St
    Vancouver, WA 98682
    (360) 768-5494
  • 10800 NE 109th Ave
    Vancouver, WA 98662
    (360) 258-0698

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Home Health

Taxonomy Code
251E00000X
Type
Agencies
Taxonomy Description
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.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

ABEBE GOBEZE

Authorized Official Title
DIRECTOR
Authorized Official Phone
(571) 665-9250

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
50D2294161
Facility Type
Other - AFH
Certificate Effective Date
November 20, 2023
Certificate Expiration Date
April 04, 2028
Laboratory Director
ABEBE GOBEZE
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Resurrection Adult Family Home Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1013629237, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
1
Doubled → 2
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
2
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
2
Unchanged
Pos 9
3
Doubled → 6
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 6 → 12 → 3 9 → 18 → 9 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 2 + 3 + 1 + 2 + 2 + 1 + 8 + 2 + 6 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1013629237.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Licensed Practical Nurse
10800 NE 109TH AVE
VANCOUVER, WA 98662
Registered Nurse
10800 NE 109TH AVE
VANCOUVER, WA 98662

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1013629237, enumerated as an "organization" on December 19, 2022.

The provider is located at 10800 NE 109TH AVE VANCOUVER, WA 98662 and the phone number is (360) 258-0698.

Home Health with taxonomy code 251E00000X.