Mountain Palms Manor Adult Family Home LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

MOUNTAIN PALMS MANOR ADULT FAMILY HOME LLC

Practice address

5120 84TH Ave W
University Place, WA 98467-1826

Phone

(803) 661-0208

Fax

(253) 240-1976

NPI assigned

Sep 8, 2022

Organization subpart

No

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

Authorized official

Name

David KinyuaNPI 1356077788

Title

Owner

Phone

(803) 661-0208

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

Practitioners 2

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

• David Kinyua

  • Licensed Practical Nurse
  • University Place, WA
  • NPI 1356077788
  NPD Authorized official
• Jacqueline Nganga, RN

  • Registered Nurse
  • University Place, WA
  • NPI 1295461499
  NPD

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

{
    "created_epoch": "1662595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662595200000",
    "number": "1801517842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 84TH AVE W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984671826",
            "telephone_number": "803-661-0208",
            "fax_number": "253-240-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 84TH AVE W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984671826",
            "telephone_number": "803-661-0208",
            "fax_number": "253-240-1976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN PALMS MANOR ADULT FAMILY HOME LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-08",
        "last_updated": "2022-09-08",
        "certification_date": "2022-09-08",
        "status": "A",
        "authorized_official_last_name": "KINYUA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-661-0208"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Shirley Morrow
• Moseman Counseling
• Christopher Adam Moseman, MA, LMHC
• Kristin L Moultine, LCSW
• Elissa Steffen Mount
• Mountains Meet Medical PLLC
• Mountains to Sound Mental Health PLLC
• Phoebe Kirigo Mugo
• Multicare Health System
• Elizabeth Claire Munday, LMHC

• Adult Care Home Facility in University Place, WA
• Providers in University Place, 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 Sep 8, 2022; 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.