# PINE MOUNTAIN RIDGE AFH LLC

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

## Provider details

- **NPI number:** 1811710692
- **Authorized official:** JUSTINE PRATHER (OWNER)
- **Authorized official phone:** (509) 845-1648

## Contact information

- **Practice address:** 590 PINE MOUNTAIN DR, YAKIMA, WA 98903-9157
- **Practice address phone:** (509) 845-1648
- **Mailing address:** 590 PINE MOUNTAIN DR, YAKIMA, WA 98903-9157
- **Mailing address phone:** (509) 845-1648

## Taxonomy

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

## Other

- **Enumeration date:** 11/01/2024
- **Last updated:** 11/01/2024