Divinity Adult Family Home, LLC
NPI #1598160186 in La Center, Washington
Provider Information
- NPI Number
- 1598160186
- Entity Type
- Organization
- Organization Name
- Divinity Adult Family Home, LLC
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Oct 26, 2014
- Last Updated
- Oct 26, 2014
Practice Location
- Address
- 38718 NE CHRISTENSEN RD
- City
- La Center
- State
- Washington
- ZIP Code
- 98629-4731
- Phone
- (360) 518-9998
Authorized Official
- Name
- AMBER LEE JACOBS, R.N.
- Title
- OWNER
- Phone
- (360) 518-9998
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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