Healthcare Provider Details

I. General information

NPI: 1336073857
Provider Name (Legal Business Name): SWEET HOME MAGNOLIA AFH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5916 S DIVISION ST
SPOKANE WA
99224-8415
US

IV. Provider business mailing address

5916 S DIVISION ST
SPOKANE WA
99224-8415
US

V. Phone/Fax

Practice location:
  • Phone: 413-459-7630
  • Fax:
Mailing address:
  • Phone: 413-459-7630
  • 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: CATHERINE AKULA
Title or Position: OWNER
Credential: REGISTERED NURSE
Phone: 413-459-7630