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General NPI Number Information
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NPI Number | 1376346593
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Entity Type | Organization
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Legal Business Name | ELEVATION AFH INC
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Dates
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Enumeration Date | 03/31/2025
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 32012 41ST AVE SW
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City | FEDERAL WAY
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State | WA
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Zip | 98023-2402
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Country | US
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Telephone | 253-517-9064
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Fax | 253-238-0260
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Provider Business Mailing Address
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Address Line | 13315 15TH AVE S
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City | TACOMA
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State | WA
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Zip | 98444-7114
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Country | US
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Telephone | 253-301-1334
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Fax | 253-238-0260
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Authorized Official
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Title or Position | PROVIDER
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Name | MRS. SUSAN MAIMBA
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Credential |
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Telephone | 253-226-0964
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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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