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NPI 1336028075

NPI 1336028075 : SHAWNEE AFH LLC : SPOKANE, WA

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General NPI Number Information
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    NPI Number           |    1336028075
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    Entity Type          |    Organization 
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    Legal Business Name  |    SHAWNEE AFH LLC 
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Dates
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    Enumeration Date     |    08/28/2025
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    Last Update Date     |    08/28/2025
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Provider Practice Location Address
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    Address Line         |    5217 W SHAWNEE AVE 
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    City                 |    SPOKANE
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    State                |    WA
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    Zip                  |    99208-9403
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    Country              |    US
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    Telephone            |    509-816-2351
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5217 W SHAWNEE AVE 
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    City                 |    SPOKANE
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    State                |    WA
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    Zip                  |    99208-9403
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    Country              |    US
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    Telephone            |    509-655-6550
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    Fax                  |    
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Authorized Official
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    Title or Position    |    PROVIDER
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    Name                 |     IAN  NDIRITU 
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    Credential           |    
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    Telephone            |    509-655-6550
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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       |    
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    License Number State |    
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