Vine Maple Care Home LLC
NPI #1154891224 in Lakewood, Washington
Provider Information
- NPI Number
- 1154891224
- Entity Type
- Organization
- Organization Name
- Vine Maple Care Home LLC
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Nov 30, 2018
- Last Updated
- Nov 30, 2018
Practice Location
- Address
- 12530 VINE MAPLE DR SW
- City
- Lakewood
- State
- Washington
- ZIP Code
- 98499-1134
- Phone
- (253) 301-0099
Authorized Official
- Name
- LUZVIMINDA IMPERIAL MONAGHAN, REGISTERED NURSE
- Title
- OWNER/PROVIDER
- Phone
- (253) 301-0099
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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