NPI 1043055510

Guardian Manor LLC

Organisation Adult Care Home Facility Mountlake Terrace, WA

Practice location

Address: 23105 53rd Ave W, Mountlake Terrace, WA 98043-4703
Phone: (206) 229-0754

Authorised official

Name: Hanna Gizaw
Title: Provider
Phone: (206) 229-0754

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

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Registry record

NPI: 1043055510
Entity type: Organization
NPI issued: 27 Jun 2024
Record last updated: 27 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.