| NPI | 1174740112 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEAN BOLDOR Menager 425-643-4669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 300503) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2020-08-22 |