Angel Vine Afh LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

ANGEL VINE AFH LLC

Doing business as

Angel Vine AFH

Practice address

275 W Vine St
Napavine, WA 98532-7641

Phone

(360) 262-3406

Fax

(360) 242-0125

NPI assigned

Feb 2, 2021

Organization subpart

No

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

Authorized official

Name

Joshua Russell Wachter, RNNPI 1275140832

Title

Owner/Partner

Phone

(360) 880-1751

Specialties & licenses 1

Addresses

Other names 1

• Angel Vine AFH Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua Russell Wachter, RN

  • Registered Nurse
  • Napavine, WA
  • NPI 1275140832
  NPD Authorized official

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612224000000",
    "number": "1427649433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 SCHOOLHOUSE RD",
            "city": "WINLOCK",
            "state": "WA",
            "postal_code": "985969718",
            "telephone_number": "360-880-1751",
            "fax_number": "360-242-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 W VINE ST",
            "city": "NAPAVINE",
            "state": "WA",
            "postal_code": "985327641",
            "telephone_number": "360-262-3406",
            "fax_number": "360-242-0125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL VINE AFH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-01",
        "status": "A",
        "authorized_official_last_name": "WACHTER",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "360-880-1751",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angel Vine AFH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hannah Marie Berscheid, L.M.P
• Spencer Blosl, L.M.P
• Brianne Brumback, LMP
• Joshua Lee Chisnell
• Lori L Cichosz, LMP

• Adult Care Home Facility in Napavine, WA
• Providers in Napavine, WA by specialty
• Adult Care Home Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2021; 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.