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General NPI Number Information
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NPI Number | 1396176699
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Entity Type | Organization
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Legal Business Name | SAHARA ADULT FAMILY HOME INC.
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Dates
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Enumeration Date | 12/12/2013
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 4913 61ST DR NE
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City | MARYSVILLE
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State | WA
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Zip | 98270-7552
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Country | US
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Telephone | 360-913-0152
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Fax |
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Provider Business Mailing Address
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Address Line | 4913 61ST DR NE
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City | MARYSVILLE
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State | WA
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Zip | 98270-7552
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Country | US
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Telephone | 360-913-0152
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. BALJEET KAUR HANS
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Credential |
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Telephone | 360-913-0152
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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 | 750156
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License Number State | WA
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