Provider Demographics
NPI:1184599110
Name:SHUNAMMITE ADULT FAMILY HOMES LLC
Entity type:Organization
Organization Name:SHUNAMMITE ADULT FAMILY HOMES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:K
Authorized Official - Last Name:KAIBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-213-0571
Mailing Address - Street 1:9825 79TH ST SW
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98498-3207
Mailing Address - Country:US
Mailing Address - Phone:253-213-0571
Mailing Address - Fax:
Practice Address - Street 1:9825 79TH ST SW
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98498-3207
Practice Address - Country:US
Practice Address - Phone:253-213-0571
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-08
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376G00000XNursing Service Related ProvidersNursing Home AdministratorGroup - Single Specialty