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Organization
SHINE LIFE ADULT FAMILY HOME LLC
Active
Organization
SHINE LIFE ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL MAMO ABEBE (ADMINISTRATOR)
(206) 859-0065
Entity
Organization
Contact information
Practice address
21823 58TH AVE W, MOUNTLAKE TERRACE, WA 98043-3129
(425) 774-7073
(425) 775-1070
Mailing address
21823 58TH AVE W, MOUNTLAKE TERRACE, WA 98043-3129
(425) 774-7073
(425) 775-1070
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
NULL
Other
Enumeration date
10/06/2026
Last updated
10/06/2026
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