| NPI | 1669895454 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VALERIE FAYE JOHNSON President 509-460-1825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility Adult Care Home (Licence: WA 750575) |
| Enumeration Date | 2014-01-29 |
| Last Update Date | 2014-01-29 |