Organization
GOLDEN PARK LANE AFH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN MUGURE KAMAU (OWNER)
(763) 221-6964
Entity
Organization
Contact information
Practice address
34628 14TH PL SW, FEDERAL WAY, WA 98023-7038
(763) 221-6964
(253) 344-1464
Mailing address
34628 14TH PL SW, FEDERAL WAY, WA 98023-7038
(763) 221-6964
(253) 344-1464
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
311ZA0620X
—
WA
Enumeration date
10/20/2022
Last updated
10/20/2022
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