NPI 1184319063

Lydie Adult Family Home LLC

Organisation Nursing Care Agency Tacoma, WA

Practice location

Address: 11019 50th Ave E, Tacoma, WA 98446-5303
Phone: (206) 850-9109
Mailing address: 16816 116th Avenue CT E, Puyallup, WA 98374-9119

Authorised official

Name: Jean Sylvain Miseso Kabuya
Title: Provider
Phone: (206) 850-9109

Registered specialties

Nursing Care Agency Primary

Agencies Taxonomy 251J00000X

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Registry record

NPI: 1184319063
Entity type: Organization
NPI issued: 6 Apr 2023
Record last updated: 6 Apr 2023

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.