Organization
ANGEL VINE AFH LLC
Active
Other names
Angel Vine AFH
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA RUSSELL WACHTER RN (OWNER/PARTNER)
(360) 880-1751
Entity
Organization
Contact information
Practice address
275 W VINE ST, NAPAVINE, WA 98532-7641
(360) 262-3406
(360) 242-0125
Mailing address
199 SCHOOLHOUSE RD, WINLOCK, WA 98596-9718
(360) 880-1751
(360) 242-0125
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
02/02/2021
Last updated
02/02/2021
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