MEDICARE: WAMS SERENE AFH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1154265965
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAMS SERENE AFH LLC

Provider Business Mailing Address
First Line	:	502 E TIETON AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-1120
Country	:	US
Telephone Number	:	774-242-7650
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 E TIETON AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99218-1120
Country	:	US
Telephone Number	:	774-242-7650
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ADMINISTRATOR
Name	:	MARYANNE NJUIRI
Credential	:
Telephone Number	:	774-242-7650

Provider Enumeration Date	:	04/14/2026
Last Update Date	:	04/14/2026

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