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General NPI Number Information
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NPI Number | 1821785833
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Entity Type | Organization
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Legal Business Name | ANGEL STARS AFH LLC
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Dates
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Enumeration Date | 04/19/2023
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 484 S 190TH ST
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City | BURIEN
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State | WA
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Zip | 98148-2044
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Country | US
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Telephone | 206-954-6431
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Fax |
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Provider Business Mailing Address
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Address Line | 484 S 190TH ST
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City | BURIEN
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State | WA
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Zip | 98148-2044
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Country | US
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Telephone | 206-954-6431
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Fax | 800-573-7095
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Authorized Official
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Title or Position | MANAGER
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Name | GLADYS KIIRU
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Credential | MBA
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Telephone | 206-954-6431
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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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