Golden Community Care Adult Family Home, LLC
Custodial Care Facility, Adult Care Home in Spokane Valley, WA. Organization (NPI-2).
NPI number1164055091
StatusActive
Last updated in NPPESFeb 19, 2020
Details
- NPI
- 1164055091
- Entity type
- Organization (NPI-2)
- Legal business name
- Golden Community Care Adult Family Home, LLC
- Organization subpart
- No
- Enumeration date
- Feb 19, 2020
- Certification date
- Feb 19, 2020
- Last updated
- Feb 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 311ZA0620X | Custodial Care Facility, Adult Care Home | – | – | Yes |
Practice location
12121 E Mission Ave Ste CSpokane Valley, WA 99206-4832
Phone 509-443-3102
Mailing address
12121 E Mission Ave Ste CSpokane Valley, WA 99206-4832
Phone 509-443-3102
Authorized official
Mahoulome Harold Guidi
Owner/Provider
5092807164
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