Organization
INFINITE GRACE ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH GAN (PROVIDER)
(425) 327-2690
Entity
Organization
Contact information
Practice address
6113 188TH ST SW, LYNNWOOD, WA 98037-7247
(425) 327-2690
Mailing address
8120 HARDESON RD UNIT 4158, EVERETT, WA 98204-0109
(425) 327-2690
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Enumeration date
10/09/2024
Last updated
12/07/2024
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