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VINE MAPLE CARE HOME LLC
NPI 1154891224
Custodial Care Facility - Adult Care Home in Lakewood, WA

Active since November 30, 2018CLIA 50D2277173 · Waiver
12530 VINE MAPLE DR SW, LAKEWOOD, WA 98499(253) 301-0099(253) 235-3645 Get Directions Write a Review

NPPES record last updated: November 30, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Vine Maple Care Home Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VINE MAPLE CARE HOME LLC (NPI 1154891224) is a healthcare organization registered as an adult care home in Lakewood, Washington and active in the NPI registry since November 2018. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Luzviminda Imperial Monaghan, Owner/provider, as its authorized official.

NPPES Registry Identity

NPI1154891224
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameVINE MAPLE CARE HOME LLC
Location Address12530 VINE MAPLE DR SWLakewood, WA 98499-1134
Mailing Address12530 Vine Maple Dr SwLakewood, WA 98499-1134 · (253) 301-0099 · Fax (253) 235-3645
Phone(253) 301-0099
Fax(253) 235-3645
Organization SubpartNo
Authorized OfficialLuzviminda Imperial MonaghanOwner/provider · (253) 301-0099
Enumeration DateNovember 30, 2018
✔ NPI 1154891224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCustodial Care Facility · Adult Care HomeNursing & Custodial Care Facilities
Taxonomy Code311ZA0620X
Definition
A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment.
12530 VINE MAPLE DR SW, Lakewood, WA 98499
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Other Identifiers 1

Medicaid2107449WA

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2277173

Vine Maple Care Home LLC · Lakewood, WA
Active · expires Apr 4, 2028
CLIA Number50D2277173
Laboratory TypeAfh
Certificate Effective DateMay 3, 2024
Certificate Expiration DateApril 4, 2028
Laboratory DirectorLuzviminda Monaghan
Laboratory Phone(253) 301-0099
Laboratory LocationVine Maple Care Home LLC12530 Vine Maple Dr SW, Lakewood, WA 98499
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. LUZVIMINDA IMPERIAL MONAGHAN
Registered Nurse (Administrator)
12530 VINE MAPLE DR SW
LAKEWOOD, WA 98499
Pierce County (253) 292-7698
ANTONIA C WILSON
Registered Nurse
12530 VINE MAPLE DR SW
LAKEWOOD, WA 98499
Pierce County (253) 301-0099
MARIA CRISTINA WALSH REGISTERED NURSE
Registered Nurse
12530 VINE MAPLE DR SW
LAKEWOOD, WA 98499
Pierce County (253) 301-0099

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vine Maple Care Home LLC's NPI number?

The NPI number for Vine Maple Care Home LLC is 1154891224. It was assigned to this organization in the NPPES registry on November 30, 2018.

Where is Vine Maple Care Home LLC located?

Vine Maple Care Home LLC is located at 12530 Vine Maple Dr SW, Lakewood, WA 98499. The listed phone number is (253) 301-0099.

What is Vine Maple Care Home LLC's specialty?

The primary specialty registered for this NPI is Custodial Care Facility, specializing in Adult Care Home, with taxonomy code 311ZA0620X.

Does Vine Maple Care Home LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2277173) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Vine Maple Care Home LLC was last updated on November 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.