| NPI | 1164803383 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAIRUZA STEVENSON Owner 360-607-8028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: WA 752667) |
| Enumeration Date | 2015-06-12 |
| Last Update Date | 2015-06-12 |