Provider Demographics
NPI:1770314536
Name:PERFECT PEACE ADULT FAMILY HOME LLC
Entity type:Organization
Organization Name:PERFECT PEACE ADULT FAMILY HOME LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIRGUT
Authorized Official - Middle Name:
Authorized Official - Last Name:ASHENAFFI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-408-3507
Mailing Address - Street 1:20506 POPLAR WAY
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-7842
Mailing Address - Country:US
Mailing Address - Phone:425-408-3507
Mailing Address - Fax:425-658-9207
Practice Address - Street 1:20506 POPLAR WAY
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-7842
Practice Address - Country:US
Practice Address - Phone:425-408-3507
Practice Address - Fax:425-658-9207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-12
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home