NPI 1093634040

Lively Care Afh LLC

Organisation Adult Care Home Facility Vancouver, WA

Practice location

Address: 16412 NE 78th Way, Vancouver, WA 98682-1512
Phone: (503) 739-4134

Authorised official

Name: Muqtar Ibrahim Mohamed
Title: Owner/Administrator
Phone: (503) 739-4134

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

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Registry record

NPI: 1093634040
Entity type: Organization
NPI issued: 14 Jul 2026
Record last updated: 14 Jul 2026

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.