| NPI | 1528495611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMINGA MARINO Provider 206-972-2205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 751972) |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |