Provider Demographics
NPI:1689309874
Name:AMANI PALACE AFH LLC
Entity Type:Organization
Organization Name:AMANI PALACE AFH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:MWAURA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:206-552-6423
Mailing Address - Street 1:5111 HARBOR VIEW DR
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-1851
Mailing Address - Country:US
Mailing Address - Phone:206-552-6423
Mailing Address - Fax:253-322-1589
Practice Address - Street 1:5111 HARBOR VIEW DR
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98422-1851
Practice Address - Country:US
Practice Address - Phone:206-552-6423
Practice Address - Fax:253-322-1589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home