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Organization
ANGEL VINE AFH LLC
Active
Organization
ANGEL VINE AFH LLC
Active
Other names
Angel Vine AFH
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA RUSSELL WACHTER RN (OWNER/PARTNER)
(360) 880-1751
Entity
Organization
Contact information
Practice address
275 W VINE ST, NAPAVINE, WA 98532-7641
(360) 262-3406
(360) 242-0125
Mailing address
199 SCHOOLHOUSE RD, WINLOCK, WA 98596-9718
(360) 880-1751
(360) 242-0125
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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