| NPI | 1780859330 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERMELINDA V KNUPP Adult Fam Home Provider 253-875-6663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: WA 750777) |
| Enumeration Date | 2008-04-24 |
| Last Update Date | 2008-04-24 |