Provider Demographics
NPI:1154947802
Name:ALLAN'S PLACE EXTENDED COMFORT CARE LLC
Entity type:Organization
Organization Name:ALLAN'S PLACE EXTENDED COMFORT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALLAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WAIGERA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:509-309-2748
Mailing Address - Street 1:3134 E 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-5110
Mailing Address - Country:US
Mailing Address - Phone:774-313-0201
Mailing Address - Fax:509-357-1308
Practice Address - Street 1:3134 E 15TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-5110
Practice Address - Country:US
Practice Address - Phone:774-313-0201
Practice Address - Fax:509-357-1308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home