Organization
STAR LAKE ADULT FAMILY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VASILICA DAVID NAR (OWNER/PROVIDER)
(253) 859-3220
Entity
Organization
Contact information
Practice address
3509 S 272ND ST, KENT, WA 98032-7062
(253) 859-3220
(253) 854-0494
Mailing address
3509 S 272ND ST, KENT, WA 98032-7062
(253) 859-3220
(253) 854-0494
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
750042
WA
Other
Enumeration date
03/11/2008
Last updated
06/17/2008
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