Organization
CERTIFIED CARE ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL UDOMA (PROVIDER)
(863) 512-1570
Entity
Organization
Contact information
Practice address
4111 W ROWAN AVE, SPOKANE, WA 99205-7665
(863) 512-1570
Mailing address
4111 W ROWAN AVE, SPOKANE, WA 99205-7665
(863) 512-1570
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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