| NPI | 1053769844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID AGNOR Executive Director 360-253-4912 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA PY1511) |
| Enumeration Date | 2016-06-02 |
| Last Update Date | 2016-06-02 |