# SUNDANCE ADULT FAMILY HOME LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sundance Adult Family Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629785159
- **Authorized official:** MS. SUSAN MWIKLAI WAWERU RN (MANAGER)
- **Authorized official phone:** (508) 612-3875

## Contact information

- **Practice address:** 10216 N SUNDANCE DR, SPOKANE, WA 99208-9315
- **Practice address phone:** (509) 315-5779
- **Practice address fax:** (509) 984-6291
- **Mailing address:** 10216 N SUNDANCE DR, SPOKANE, WA 99208-9315
- **Mailing address phone:** (509) 315-5779
- **Mailing address fax:** (509) 984-6291

## Taxonomy

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

## Other

- **Enumeration date:** 11/03/2022
- **Last updated:** 11/11/2022