Lively Care Afh LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

LIVELY CARE AFH LLC

Practice address

16412 NE 78TH Way
Vancouver, WA 98682-1512

Phone

(503) 739-4134

NPI assigned

Jul 14, 2026

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Muqtar Ibrahim Mohamed

Title

Owner/Administrator

Phone

(503) 739-4134

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1783987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783987200000",
    "number": "1093634040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16412 NE 78TH WAY",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986821512",
            "telephone_number": "503-739-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16412 NE 78TH WAY",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986821512",
            "telephone_number": "503-739-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVELY CARE AFH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-14",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "MUQTAR",
        "authorized_official_middle_name": "IBRAHIM",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "503-739-4134"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.