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NPI 1457173585

NPI 1457173585 : ABCARE ADULT FAMILY HOME LLC : SPOKANE, WA

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General NPI Number Information
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    NPI Number           |    1457173585
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    Entity Type          |    Organization 
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    Legal Business Name  |    ABCARE ADULT FAMILY HOME LLC 
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Dates
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    Enumeration Date     |    10/29/2024
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    Last Update Date     |    10/29/2024
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Provider Practice Location Address
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    Address Line         |    1415 W CHERRYWOOD CT 
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    City                 |    SPOKANE
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    State                |    WA
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    Zip                  |    99218-2999
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    Country              |    US
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    Telephone            |    509-202-8477
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    1415 W CHERRYWOOD CT 
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    City                 |    SPOKANE
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    State                |    WA
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    Zip                  |    99218-2999
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    Country              |    US
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    Telephone            |    509-202-8477
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    Fax                  |    
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Authorized Official
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    Title or Position    |    MANAGER
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    Name                 |     JACOB NTAOTI SEERU 
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    Credential           |    
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    Telephone            |    509-202-8477
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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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