Organization
MOUNTAIN PALMS MANOR ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KINYUA (OWNER)
(803) 661-0208
Entity
Organization
Contact information
Practice address
5120 84TH AVE W, UNIVERSITY PLACE, WA 98467-1826
(803) 661-0208
(253) 240-1976
Mailing address
5120 84TH AVE W, UNIVERSITY PLACE, WA 98467-1826
(803) 661-0208
(253) 240-1976
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
09/08/2022
Last updated
09/08/2022
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