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General NPI Number Information
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NPI Number | 1912819749
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Entity Type | Organization
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Legal Business Name | HOMESTEAD PARK AFH LLC
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 1821 SE SOLOMON LOOP
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City | VANCOUVER
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State | WA
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Zip | 98683-4631
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Country | US
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Telephone | 360-721-6666
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Fax | 360-334-9955
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Provider Business Mailing Address
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Address Line | 1821 SE SOLOMON LOOP
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City | VANCOUVER
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State | WA
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Zip | 98683-4631
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Country | US
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Telephone | 360-721-6666
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Fax | 360-334-9955
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Authorized Official
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Title or Position | OWNER
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Name | IANN BARRANTES-RAMIREZ
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Credential | PROVIDER
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Telephone | 360-721-6666
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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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