Provider Demographics
NPI:1316793268
Name:FAITH HOUSE AFH LLC
Entity type:Organization
Organization Name:FAITH HOUSE AFH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:
Authorized Official - Last Name:MUGURE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-252-9845
Mailing Address - Street 1:37630 165TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-9495
Mailing Address - Country:US
Mailing Address - Phone:253-252-9845
Mailing Address - Fax:
Practice Address - Street 1:37630 165TH AVE SE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-9495
Practice Address - Country:US
Practice Address - Phone:253-252-9845
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home