| NPI | 1578273231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA-TAJIRI NYAGONCHONGA Provider 509-306-4371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home |
| Enumeration Date | 2022-12-02 |
| Last Update Date | 2022-12-02 |