# RAHA ADULT FAMILY HOME LLC

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

## Provider details

- **NPI number:** 1093447617
- **Authorized official:** MS. NASRA ABDULLAHI MOHAMUD RN, MSN (PROVIDER/OWNER)
- **Authorized official phone:** (253) 205-5780

## Contact information

- **Practice address:** 2835 S 148TH ST, SEATAC, WA 98168-4245
- **Practice address phone:** (253) 205-5780
- **Practice address fax:** (253) 322-2317
- **Mailing address:** 2835 S 148TH ST, SEATAC, WA 98168-4245
- **Mailing address phone:** (253) 205-5780
- **Mailing address fax:** (253) 322-2317

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 06/30/2022
- **Last updated:** 06/30/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 755672 | DSHS | WA |