Organization
CLOVERSTONE ADULT FAMILY HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EBONY JAITEH HOME CARE AIDE (OWNER/ADMINISTRATION MANAGER)
(414) 698-4649
Entity
Organization
Contact information
Practice address
1829 W MISSION AVE UNIT A, SPOKANE, WA 99201-2837
(414) 698-4649
Mailing address
1829 W MISSION AVE UNIT A, SPOKANE, WA 99201-2837
(414) 698-4649
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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