Healthcare Provider Details

I. General information

NPI: 1205767944
Provider Name (Legal Business Name): CYPRESS PLACE ADULT FAMILY HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2026
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11506 E 13TH LN
SPOKANE VALLEY WA
99206-1500
US

IV. Provider business mailing address

11506 E 13TH LN
SPOKANE VALLEY WA
99206-1500
US

V. Phone/Fax

Practice location:
  • Phone: 281-650-2280
  • Fax:
Mailing address:
  • Phone: 281-650-2280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ANGELIUS NJAGI
Title or Position: OWNER
Credential: RN
Phone: 281-650-2280