Grande Creek Afh LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

GRANDE CREEK AFH LLC

Practice address

3105 N Rio Grande Rd
Spokane Valley, WA 99027-5016

Phone

(509) 869-3961

NPI assigned

May 12, 2026

Organization subpart

No

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

Authorized official

Name

Anne Mutuku

Title

Provider/Owner

Phone

(509) 869-3961

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1778544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782864000000",
    "number": "1780512459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3105 N RIO GRANDE RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990275016",
            "telephone_number": "509-869-3961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3105 N RIO GRANDE RD",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990275016",
            "telephone_number": "509-869-3961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRANDE CREEK AFH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-12",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A",
        "authorized_official_last_name": "MUTUKU",
        "authorized_official_first_name": "ANNE",
        "authorized_official_title_or_position": "PROVIDER/OWNER",
        "authorized_official_telephone_number": "509-869-3961"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chamellia Graham
• Diane Michelle Graham
• Ebony Montezz Graham
• James Scott Graham, M.S.
• Kelsey Michelle Graham, LMFT
• Veronica Granger, RN
• Keric Lester Gray, LMP
• Melissa Gray, M.A.
• Stacy Gray, ARNP
• Ty Lynn Gray

• Adult Care Home Facility in Spokane Valley, WA
• Providers in Spokane Valley, 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 Jul 1, 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.