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General NPI Number Information
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NPI Number | 1750224135
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Entity Type | Organization
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Legal Business Name | JEWEL ADULT FAMILY HOME LLC
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Dates
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Enumeration Date | 04/11/2026
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Last Update Date | 04/11/2026
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Provider Practice Location Address
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Address Line | 300 NW TRUE ST
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City | PULLMAN
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State | WA
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Zip | 99163-3347
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Country | US
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Telephone | 509-715-8326
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Fax | 509-338-9169
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Provider Business Mailing Address
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Address Line | 300 NW TRUE ST
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City | PULLMAN
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State | WA
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Zip | 99163-3347
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Country | US
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Telephone | 509-715-8326
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Fax | 509-338-9169
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOHN MAKAU KIVUVA
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Credential | PROVIDER
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Telephone | 509-715-8326
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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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