Converge Afh Corp

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

CONVERGE AFH CORP

Practice address

2920 SW 323Rd St
Federal Way, WA 98023-2523

Phone

(206) 734-4540

Fax

(206) 701-0874

NPI assigned

Jun 5, 2024

Last updated

Jun 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mathew Kirori

Title

Owner

Phone

(206) 734-4540

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717545600000",
    "number": "1962243766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 SW 323RD ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232523",
            "telephone_number": "206-734-4540",
            "fax_number": "206-701-0874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2920 SW 323RD ST",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232523",
            "telephone_number": "206-734-4540",
            "fax_number": "206-701-0874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "909 5th St NE",
            "address_purpose": "LOCATION",
            "city": "Auburn",
            "state": "WA",
            "postal_code": "980024345",
            "country_code": "US",
            "telephone_number": "206-734-4540",
            "fax_number": "206-701-0874",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CONVERGE AFH CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A",
        "authorized_official_last_name": "KIRORI",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-734-4540"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Consano Afh LLC
• Consolidated Resources Health Care Fund I, L.P. (Life Care Center of Federal Way)
• Consolidated Resources Health Care Fund I, LP (Hallmark Manor)
• Dylan Constantino, MD
• Continuing Behavior Support TX
• Ellen J. Cook, COTA/L
• Jennifer Cook, LMP
• David W Cooper, ARNP
• Lucas Mark Reyes Cooper, BSN, RN
• Ella Coots

• Adult Care Home Facility in Federal Way, WA
• Providers in Federal Way, 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 Jun 5, 2024; 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.