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General NPI Number Information
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NPI Number | 1053736280
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Entity Type | Organization
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Legal Business Name | L'ARCHE SPOKANE
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Dates
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Enumeration Date | 02/25/2014
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 703 E NORA AVE
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City | SPOKANE
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State | WA
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Zip | 99207-2455
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Country | US
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Telephone | 509-483-0438
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Fax | 509-483-0460
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Provider Business Mailing Address
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Address Line | 703 E NORA AVE
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City | SPOKANE
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State | WA
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Zip | 99207-2455
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Country | US
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Telephone | 509-483-0438
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Fax | 509-483-0460
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Authorized Official
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Title or Position | PRESIDENT, BOARD OF DIRECTORS
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Name | MICHAEL D MILLER
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Credential |
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Telephone | 509-991-4141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 617400
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 223400
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License Number State | WA
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