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FOREST PARK ADULT FAMILY HOME INC NPI 1760887830


NPI Information

NPI: 1760887830
Provider Name: FOREST PARK ADULT FAMILY HOME INC
Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

CLIA Number: 50D2275287

Address:
17522 SE 338TH ST
AUBURN, WA
ZIP 98092
Phone: (253) 833-4815
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FOREST PARK ADULT FAMILY HOME INC is an adult care home custodial care facility in Auburn, WA. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. FOREST PARK ADULT FAMILY HOME INC NPI is 1760887830. The provider is registered as an organization entity type.

The provider's business location address is:

17522 SE 338TH ST
AUBURN, WA
ZIP 98092-212
Phone: (253) 833-4815

The provider's authorized official is Florica Mihaila .
The authorized official title is Owner and has the following contact phone number (253) 833-4815.

The CLIA number assigned to this NPI record is 50D2275287 - other - afh with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/30/2014 and was last updated on 10/30/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care Home752403WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1279683MEDICAIDWASHINGTON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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