Provider Demographics
NPI:1275223976
Name:OSPREY AT CARNAHAN ADULT FAMILY HOME
Entity Type:Organization
Organization Name:OSPREY AT CARNAHAN ADULT FAMILY HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:NICOLE
Authorized Official - Last Name:PREY
Authorized Official - Suffix:
Authorized Official - Credentials:DNP
Authorized Official - Phone:509-944-1361
Mailing Address - Street 1:2921 N CARNAHAN ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217-5124
Mailing Address - Country:US
Mailing Address - Phone:509-290-6647
Mailing Address - Fax:205-528-6242
Practice Address - Street 1:2921 N CARNAHAN ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217-5124
Practice Address - Country:US
Practice Address - Phone:509-290-6647
Practice Address - Fax:205-528-6242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home