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Organization

DEVINE CARE SUPPORTED LIVING CORPORATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTINE MUNYIRI (CEO)
(253) 240-7463
Entity
Organization

Contact information

Practice address
1400 112TH AVE SE STE 100, BELLEVUE, WA 98004-6901
(253) 240-7463
Mailing address
1400 112TH AVE SE STE 100, BELLEVUE, WA 98004-6901
(253) 240-7463

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other

Enumeration date
11/25/2024
Last updated
11/25/2024
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