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General NPI Number Information
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NPI Number | 1467276238
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Entity Type | Organization
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Legal Business Name | AWESOME CARE AFH LLC
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Dates
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Enumeration Date | 11/08/2024
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Last Update Date | 11/08/2024
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Provider Practice Location Address
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Address Line | 21028 121ST PL SE
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City | KENT
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State | WA
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Zip | 98031-2249
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Country | US
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Telephone | 253-753-3974
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Fax | 253-981-4821
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Provider Business Mailing Address
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Address Line | 21028 121ST PL SE
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City | KENT
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State | WA
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Zip | 98031-2249
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Country | US
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Telephone | 253-753-3974
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Fax | 253-981-4821
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Authorized Official
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Title or Position | PROVIDER
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Name | MOUSSA DIAWARA
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Credential | CNA
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Telephone | 253-753-3974
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372500000X
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Taxonomy Name | Chore Provider
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License Number |
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License Number State |
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