# STAR LAKE ADULT FAMILY HOME

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

## Provider details

- **NPI number:** 1932379534
- **Authorized official:** MRS. VASILICA DAVID NAR (OWNER/PROVIDER)
- **Authorized official phone:** (253) 859-3220

## Contact information

- **Practice address:** 3509 S 272ND ST, KENT, WA 98032-7062
- **Practice address phone:** (253) 859-3220
- **Practice address fax:** (253) 854-0494
- **Mailing address:** 3509 S 272ND ST, KENT, WA 98032-7062
- **Mailing address phone:** (253) 859-3220
- **Mailing address fax:** (253) 854-0494

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | 750042 | WA | Yes |

## Other

- **Enumeration date:** 03/11/2008
- **Last updated:** 06/17/2008