Star Lake Adult Family Home
NPI #1932379534 in Kent, Washington
Provider Information
- NPI Number
- 1932379534
- Entity Type
- Organization
- Organization Name
- Star Lake Adult Family Home
- Primary Specialty
- Custodial Care Facility - Adult Care Home
- Enumeration Date
- Mar 11, 2008
- Last Updated
- Jun 17, 2008
Practice Location
- Address
- 3509 S 272ND ST
- City
- Kent
- State
- Washington
- ZIP Code
- 98032-7062
- Phone
- (253) 859-3220
Authorized Official
- Name
- MRS. VASILICA DAVID, NAR
- Title
- OWNER/PROVIDER
- Phone
- (253) 859-3220
Specialties & Taxonomy Codes
| Specialty |
|---|
| Custodial Care Facility - Adult Care Home — Adult Care Home |
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