| NPI | 1568800035 |
|---|---|
| Doing Business As | CANYON CREEK ADULT FAMILY HOME |
| Entity Type | Organization |
| Authorized Contact | DARREN DAVID VIERCK President 360-907-3997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: WA 456900) |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2013-06-06 |