GRANDE CREEK AFH LLC NPI 1780512459

NPI Information

  • NPI: 1780512459
  • Provider Name: GRANDE CREEK AFH LLC
  • Classification: Custodial Care Facility - 311ZA0620X
  • Specialization: Adult Care Home
  • Entity Type: Organization
  • Address: 3105 N RIO GRANDE RD
    OTIS ORCHARDS, WA
    ZIP 99027
  • Phone: (509) 869-3961

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NPI Details

GRANDE CREEK AFH LLC is an adult care home custodial care facility in Otis Orchards, 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. GRANDE CREEK AFH LLC NPI is 1780512459. The provider is registered as an organization entity type.

The provider's business location address is:

3105 N RIO GRANDE RD
OTIS ORCHARDS, WA
ZIP 99027-016
Phone: (509) 869-3961

The provider's authorized official is Anne Mutuku .
The authorized official title is Provider/owner and has the following contact phone number (509) 869-3961.

The enumeration date for this NPI number is 5/12/2026 and was last updated on 5/12/2026.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1311ZA0620XCustodial Care FacilityAdult Care HomeYes

What is NPI?

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This page was last updated on: 11/21/2025

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