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Organization
2021 BOULEVARD COHOUSING LLC
Active
Organization
2021 BOULEVARD COHOUSING LLC
Active
Other names
2021 Boulevard
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL IRWIN STUSSER (MANAGING PARTNER)
(360) 259-5000
Entity
Organization
Contact information
Practice address
2021 BOULEVARD RD SE, OLYMPIA, WA 98501-3227
(360) 259-5000
(360) 357-7049
Mailing address
PO BOX 4008, OLYMPIA, WA 98501-0008
(360) 259-5000
(360) 357-7049
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
03/19/2024
Last updated
03/19/2024
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