1912852161 NPI number — SMILING HEART ADULT FAMILY HOME LLC

Table of content: (NPI 1912852161)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912852161 NPI number — SMILING HEART ADULT FAMILY HOME LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SMILING HEART ADULT FAMILY HOME LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1912852161
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
62 W SHORE AVE SW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKEWOOD
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98498-5840
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-212-2079
Provider Business Mailing Address Fax Number:
253-503-2079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
62 W SHORE AVE SW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKEWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98498-5840
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-212-2079
Provider Business Practice Location Address Fax Number:
253-503-1960
Provider Enumeration Date:
03/03/2026

Additional Information

Authorized Official

Authorized Official Last Name:
KIMOTHO
Authorized Official First Name:
THUWEBA
Authorized Official Middle Name:
NDUNGE
Authorized Official Title or Position:
PROVIDER/OWNER
Authorized Official Telephone Number:
253-632-9374

Provider Taxonomy Codes

  • Taxonomy code: 376G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com