=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861340275
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MILE HIGH ADULT FAMILY HOME LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/20/2026
-----------------------------------------------------
Last Update Date | 03/20/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 12720 159TH ST E
-----------------------------------------------------
City | PUYALLUP
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98374-9115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-990-4547
-----------------------------------------------------
Fax | 206-339-1584
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 12720 159TH ST E
-----------------------------------------------------
City | PUYALLUP
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98374-9115
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-990-4547
-----------------------------------------------------
Fax | 206-339-1584
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | JONES G MUHIA
-----------------------------------------------------
Credential | MUHIA
-----------------------------------------------------
Telephone | 206-990-4547
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 376K00000X
-----------------------------------------------------
Taxonomy Name | Nurse's Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------