Healthcare Provider Details

I. General information

NPI: 1912819749
Provider Name (Legal Business Name): HOMESTEAD PARK AFH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1821 SE SOLOMON LOOP
VANCOUVER WA
98683-4631
US

IV. Provider business mailing address

1821 SE SOLOMON LOOP
VANCOUVER WA
98683-4631
US

V. Phone/Fax

Practice location:
  • Phone: 360-721-6666
  • Fax: 360-334-9955
Mailing address:
  • Phone: 360-721-6666
  • Fax: 360-334-9955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: IANN BARRANTES-RAMIREZ
Title or Position: OWNER
Credential: PROVIDER
Phone: 360-721-6666