Provider Demographics
NPI:1154146033
Name:SOUTH HILL AFH LLC II
Entity type:Organization
Organization Name:SOUTH HILL AFH LLC II
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIMON
Authorized Official - Middle Name:N
Authorized Official - Last Name:MAINA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:732-582-9512
Mailing Address - Street 1:12121 130TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98374-4443
Mailing Address - Country:US
Mailing Address - Phone:253-888-1531
Mailing Address - Fax:253-693-9963
Practice Address - Street 1:12121 130TH AVENUE CT E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98374-4443
Practice Address - Country:US
Practice Address - Phone:253-888-1531
Practice Address - Fax:253-693-9963
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty