| NPI | 1467623546 | 
|---|---|
| Doing Business As | GRANDPA'S PLACE | 
| Entity Type | Organization | 
| Authorized Contact | SARRAH HELD Owner/Provider/President 360-910-7555 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 750066) | 
| Enumeration Date | 2008-03-17 | 
| Last Update Date | 2008-03-17 |