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General NPI Number Information
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NPI Number | 1144970542
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Entity Type | Organization
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Legal Business Name | CJK COMMUNITY HOMES
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Dates
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Enumeration Date | 03/28/2022
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Last Update Date | 03/29/2022
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Provider Practice Location Address
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Address Line | 2367 TACOMA AVE S # 215
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City | TACOMA
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State | WA
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Zip | 98402-1409
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Country | US
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Telephone | 253-507-3576
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Fax |
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Provider Business Mailing Address
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Address Line | 2367 TACOMA AVE S # 215
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City | TACOMA
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State | WA
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Zip | 98402-1409
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Country | US
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Telephone | 253-507-3576
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | MRS. NOEMI S CAGATIN-PORTER
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Credential |
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Telephone | 253-507-3576
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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