Provider Demographics
NPI:1306016878
Name:MANUEL'S HOME AFH
Entity Type:Organization
Organization Name:MANUEL'S HOME AFH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORINA
Authorized Official - Middle Name:G
Authorized Official - Last Name:DELFIERRO
Authorized Official - Suffix:
Authorized Official - Credentials:AFH PROVIDER
Authorized Official - Phone:253-344-1938
Mailing Address - Street 1:4009 SW 323RD ST
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-2419
Mailing Address - Country:US
Mailing Address - Phone:253-344-1938
Mailing Address - Fax:
Practice Address - Street 1:4009 SW 323RD ST
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-2419
Practice Address - Country:US
Practice Address - Phone:253-344-1938
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-11
Last Update Date:2011-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA750597311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home