Country Living Adult Family Home
NPI #1780859330 in Spanaway, Washington
Provider Information
- NPI Number
- 1780859330
- Entity Type
- Organization
- Organization Name
- Country Living Adult Family Home
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Apr 24, 2008
- Last Updated
- Apr 24, 2008
Practice Location
- Address
- 21514 47TH AVE E
- City
- Spanaway
- State
- Washington
- ZIP Code
- 98387
- Phone
- (253) 875-6663
Authorized Official
- Name
- MRS. ERMELINDA V KNUPP
- Title
- ADULT FAM HOME PROVIDER
- Phone
- (253) 875-6663
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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