Home » Washington » 98629 » Divinity Adult Family Home, Llc

Divinity Adult Family Home, Llc

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.

physician-icon Basic Information

Practice Location 38718 Ne Christensen Rd, La Center, WA 98629-4731, US
Practice Location Phone360-518-9998
Practice Location Fax
Legal Business NameDIVINITY ADULT FAMILY HOME, LLC
NPI ?1598160186
Entity TypeOrganization
Enumeration Date ? Oct 26, 2014
Last Update Date ? Oct 26, 2014
Note:
NPI: National Provider Identifier issued to health care providers by Centers for Medicare and Medicaid Services (CMS).

specialty-icon Specialties & Licenses of Divinity Adult Family Home, Llc

SpecialtySpecializationLicenseLicense State
Custodial Care FacilityAdult Care Home 201140065RNWashington

official-icon Authorized Official of Divinity Adult Family Home, Llc

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/PositionOWNER
Authorized Official Phone Number360-518-9998