# VERDANT GROVE ADULT FAMILY HOME, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1083128375
- **Authorized official:** LILIA PEROS SADUCOS (PROVIDER)
- **Authorized official phone:** (206) 694-3513

## Contact information

- **Practice address:** 9644 54TH AVE S, SEATTLE, WA 98118-5705
- **Practice address phone:** (206) 722-2766
- **Mailing address:** 9650 54TH AVE S, SEATTLE, WA 98118-5705

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 751083 | WA | Yes |

## Other

- **Enumeration date:** 11/22/2017
- **Last updated:** 11/22/2017