| NPI | 1013679505 |
|---|---|
| Former Legal Business Name | TULELAKE AVENUE COMFORT HOME LLC |
| Entity Type | Organization |
| Authorized Contact | NGONYO MWANGI Business Operations Manager 253-533-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2021-10-12 |
| Last Update Date | 2021-10-12 |