Healthcare Provider Details

I. General information

NPI: 1295649010
Provider Name (Legal Business Name): SAFEHARBOUR HOMES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26007 132ND AVE SE
KENT WA
98042-3503
US

IV. Provider business mailing address

26007 132ND AVE SE
KENT WA
98042-3503
US

V. Phone/Fax

Practice location:
  • Phone: 206-816-9207
  • Fax: 253-479-2430
Mailing address:
  • Phone: 206-816-9207
  • Fax: 253-479-2430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376G00000X
TaxonomyNursing Home Administrator
License Number
License Number StateNULL

VIII. Authorized Official

Name: MWAI K NYASULU
Title or Position: PROVIDER
Credential:
Phone: 206-816-9207