Provider Demographics
NPI:1124455803
Name:TANYA'S ADULT FAMILY HOMES LLC
Entity type:Organization
Organization Name:TANYA'S ADULT FAMILY HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:TATYANA
Authorized Official - Middle Name:
Authorized Official - Last Name:VOLODYN
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:206-542-6196
Mailing Address - Street 1:16505 N PARK AVE N
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-5322
Mailing Address - Country:US
Mailing Address - Phone:206-542-6196
Mailing Address - Fax:
Practice Address - Street 1:16505 N PARK AVE N
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133-5322
Practice Address - Country:US
Practice Address - Phone:206-542-6196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA751608310400000X
WA751609310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility