Organization
AVIAN ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEDAN NJOROGE (OWNER/ PROVIDER)
(253) 310-1206
Entity
Organization
Contact information
Practice address
9427 194TH ST E, GRAHAM, WA 98338-8198
(253) 271-7383
Mailing address
9427 194TH ST E, GRAHAM, WA 98338-8198
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/23/2020
Last updated
07/23/2020
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