Organization
ST NINO ADULT FAMILY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REZA S VARGAS NAR (PROVIDER/OWNER)
(253) 875-9077
Entity
Organization
Contact information
Practice address
19620 8TH AVE E, SPANAWAY, WA 98387
(253) 875-9077
(253) 875-9077
Mailing address
19620 8TH AVE E, 19724 8TH AVE E SPANAWAY WA 98387, SPANAWAY, WA 98387-8478
(253) 875-9077
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
635100
WA
Other
Enumeration date
05/07/2008
Last updated
05/07/2008
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