| NPI | 1194126219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE JANEL BUSSELL-CHAMBERS Owner/ Provider 253-507-4478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 751995) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2014-09-08 |