MEDICARE: PURITY'S CALICO COTTAGE AFH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1831024967
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PURITY'S CALICO COTTAGE AFH LLC

Provider Business Mailing Address
First Line	:	11617 E 11TH AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-5492
Country	:	US
Telephone Number	:	509-263-5416
Fax Number	:	509-863-9561

Provider Business Practice Location Address
First Line	:	11617 E 11TH AVE
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-5492
Country	:	US
Telephone Number	:	509-263-5416
Fax Number	:	509-863-9561

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. PURITY N KARANJA
Credential	:
Telephone Number	:	509-263-5416

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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