Provider Demographics
NPI:1598504334
Name:MEADOW BROOK ADULT FAMILY HOME LLC
Entity type:Organization
Organization Name:MEADOW BROOK ADULT FAMILY HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AFH PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:MWANGI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-612-0692
Mailing Address - Street 1:1112 O ST NE
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-3517
Mailing Address - Country:US
Mailing Address - Phone:206-612-0692
Mailing Address - Fax:425-606-4308
Practice Address - Street 1:1112 O ST NE
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98002-3517
Practice Address - Country:US
Practice Address - Phone:206-612-0692
Practice Address - Fax:425-606-4308
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home