Organization
LIBERTY DEVELOPMENT COMPANY, LLC
Active
Other names
The Courtyard at Colfax
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHAUNA J. MILLER R. N. (PRESIDENT)
(208) 772-2743
Entity
Organization
Contact information
Practice address
300 S MAIN ST, COLFAX, WA 99111-1971
(509) 397-6123
(509) 397-6367
Mailing address
300 S MAIN ST, COLFAX, WA 99111-1971
(509) 397-6123
(509) 397-6367
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
BH 1624
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
865214
—
WA
01
—
BH 1624
WA BOARDING HOME PROVIDER
WA
Enumeration date
08/17/2006
Last updated
08/22/2020
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