# WOODBINE ADULT FAMILY HOME LLC

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

## Provider details

- **NPI number:** 1376418152
- **Authorized official:** BETTY KINOTI (PROVIDER)
- **Authorized official phone:** (253) 267-1458

## Contact information

- **Practice address:** 11608 WOODBINE LN SW, LAKEWOOD, WA 98499-1257
- **Practice address phone:** (253) 267-1458
- **Mailing address:** 11608 WOODBINE LN SW, LAKEWOOD, WA 98499-1257
- **Mailing address phone:** (253) 267-1458

## Taxonomy

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

## Other

- **Enumeration date:** 10/09/2025
- **Last updated:** 10/09/2025