Provider Demographics
NPI:1114663341
Name:1 EMPOWERING ADULT FAMILY HOME 2
Entity Type:Organization
Organization Name:1 EMPOWERING ADULT FAMILY HOME 2
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:NJUNGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-957-5679
Mailing Address - Street 1:6211 W SUNDANCE DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-9042
Mailing Address - Country:US
Mailing Address - Phone:509-957-5679
Mailing Address - Fax:509-903-0530
Practice Address - Street 1:6211 W SUNDANCE DR
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-9042
Practice Address - Country:US
Practice Address - Phone:509-957-5679
Practice Address - Fax:509-903-0530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-10
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home