Divinity Adult Family Home, Llc is a health care provider in La Center, WA. In this page you will find its mailing address, practice location, phone number, specialty etc.
|Practice Location||38718 Ne Christensen Rd, La Center, WA 98629-4731, US|
|Practice Location Phone||360-518-9998|
|Practice Location Fax|
|Legal Business Name||DIVINITY ADULT FAMILY HOME, LLC|
|Enumeration Date ?||Oct 26, 2014|
|Last Update Date ?||Oct 26, 2014|
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).
|Specialty||Provider Type||Specialization||License||License State|
|Custodial Care Facility||Nursing & Custodial Care Facilities||Adult Care Home||201140065RN||Washington|
An authorized official is an appointed official with the legal authority to make changes and/or updates to the Divinity Adult Family Home, Llc's status and to commit the provider to fully abide by the laws and regulations relating to the National Provider Identifier (NPI).
|Authorized Official||Amber Lee Jacobs (R.N.)|
|Authorized Official Title/Position||OWNER|
|Authorized Official Phone Number||360-518-9998|