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General NPI Number Information
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NPI Number | 1669364162
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Entity Type | Organization
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Legal Business Name | LAVENDER LANE ADULT FAMILY HOME
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Dates
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Enumeration Date | 07/18/2025
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 9616 N SYLVIA CT
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City | SPOKANE
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State | WA
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Zip | 99208-8632
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Country | US
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Telephone | 509-850-7442
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Fax |
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Provider Business Mailing Address
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Address Line | 6805 N BELT ST
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City | SPOKANE
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State | WA
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Zip | 99208-4301
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Country | US
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Telephone | 509-850-7442
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. PIERRE G DE LA FORCE
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Credential |
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Telephone | 509-850-7442
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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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