St Nino Adult Family Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

635100 Issued in WA

Legal business name

ST NINO ADULT FAMILY HOME

Practice address

19620 8TH Ave E
Spanaway, WA 98387

Phone

(253) 875-9077

Fax

(253) 875-9077

NPI assigned

May 7, 2008

Organization subpart

No

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

Authorized official

Name

Reza S Vargas, NAR

Title

Provider/Owner

Phone

(253) 875-9077

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1710153937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19620 8TH AVE E",
            "address_2": "19724 8TH AVE E SPANAWAY WA 98387",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "983878478",
            "telephone_number": "253-875-9077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19620 8TH AVE E",
            "city": "SPANAWAY",
            "state": "WA",
            "postal_code": "98387",
            "telephone_number": "253-875-9077",
            "fax_number": "253-875-9077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST NINO ADULT FAMILY HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "VARGAS",
        "authorized_official_first_name": "REZA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "253-875-9077",
        "authorized_official_credential": "NAR"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "WA",
            "license": "635100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Colton Kenneth Smith, DPT
• Yuliya Sobko
• Spanaway Chiropractic Clinic
• Spanaway Eyecare, P.S.
• Sri Krishnaiah Corporation
• Lean Ariane Puno Sta Maria, PHARMACIST
• Joanne Stanek
• Cristiana Naomi Stantsiyer, DC
• Amy Elizabeth Starr, M.S., CCC-SLP
• Russell Lee Steffensen, DO

• Adult Care Home Facility in Spanaway, WA
• Providers in Spanaway, 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 May 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.