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FORTUNA ADULT FAMILY HOME LLC
NPI 1861325995
Custodial Care Facility - Adult Care Home in Vancouver, WA

Active since June 08, 2026CLIA 50D2337400 · Waiver
2502 NE 110TH AVE, VANCOUVER, WA 98684(593) 459-9537 Get Directions Write a Review

NPPES record last updated: June 8, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Fortuna Adult Family Home Llc NPPES

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

FORTUNA ADULT FAMILY HOME LLC (NPI 1861325995) is a healthcare organization registered as an adult care home in Vancouver, Washington and active in the NPI registry since June 2026. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Mekdese Berhane, Owner, as its authorized official.

NPPES Registry Identity

NPI1861325995
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameFORTUNA ADULT FAMILY HOME LLC
Location Address2502 NE 110TH AVEVancouver, WA 98684-4248
Mailing Address2502 Ne 110th AveVancouver, WA 98684-4248 · (593) 459-9537
Phone(593) 459-9537
Organization SubpartNo
Authorized OfficialMekdese BerhaneOwner · (503) 459-9537
Enumeration DateJune 8, 2026
NPPES CertifiedJune 8, 2026
✔ NPI 1861325995 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition

A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.

2502 NE 110TH AVE, Vancouver, WA 98684
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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 50D2337400

Fortuna Adult Family Home · Vancouver, WA
Active · expires Apr 4, 2028
CLIA Number50D2337400
Laboratory TypeAfh
Certificate Effective DateJanuary 22, 2026
Certificate Expiration DateApril 4, 2028
Laboratory DirectorMekdese Berhane
Laboratory Phone(360) 433-2286
Laboratory LocationFortuna Adult Family Home2502 NE 110th Ave, Vancouver, WA 98684
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

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 Fortuna Adult Family Home LLC's NPI number?

The NPI number for Fortuna Adult Family Home LLC is 1861325995. It was assigned to this organization in the NPPES registry on June 8, 2026.

Where is Fortuna Adult Family Home LLC located?

Fortuna Adult Family Home LLC is located at 2502 NE 110th Ave, Vancouver, WA 98684. The listed phone number is (593) 459-9537.

What is Fortuna Adult Family Home LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

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

Yes. A Certificate of Waiver (number 50D2337400) 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 Fortuna Adult Family Home LLC was last updated on June 8, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.