SHALOM ADULT FAMILY HOME 1 LLC
NPI 1477309607
Custodial Care Facility - Adult Care Home in Tacoma, WA

Q: What is Shalom Adult Family Home 1 LLC's NPI number?

The NPI number for Shalom Adult Family Home 1 LLC is 1477309607. It was assigned to this organization in the NPPES registry on April 29, 2024.

Q: What is Shalom Adult Family Home 1 LLC's specialty?

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

Active since April 29, 2024CLIA 50D2320352 · Waiver

1102 S 72ND ST, TACOMA, WA 98408(253) 301-1875(253) 301-1949 Get Directions Write a Review

NPPES record last updated: April 29, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Shalom Adult Family Home 1 Llc NPPES

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

SHALOM ADULT FAMILY HOME 1 LLC (NPI 1477309607) is a healthcare organization registered as an adult care home in Tacoma, Washington and active in the NPI registry since April 2024. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Gloria Nansubuga, Provider, as its authorized official.

NPPES Registry Identity

NPI1477309607

Entity TypeOrganization

Primary Taxonomy311ZA0620X

Legal Business NameSHALOM ADULT FAMILY HOME 1 LLC

Location Address1102 S 72ND STTacoma, WA 98408-3007

Mailing Address1102 S 72nd StTacoma, WA 98408-3007 · (253) 301-1875 · Fax (253) 301-1949

Phone(253) 301-1875

Fax(253) 301-1949

Organization SubpartNo

Authorized OfficialGloria NansubugaProvider · (206) 501-0731

Enumeration DateApril 29, 2024

NPPES CertifiedApril 28, 2024

✔ NPI 1477309607 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.

1102 S 72ND ST, Tacoma, WA 98408

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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 50D2320352

Shalom Adult Family Home 1 LLC · Tacoma, WA

Active · expires Apr 4, 2028

CLIA Number50D2320352

Laboratory TypeAfh

Certificate Effective DateMarch 17, 2025

Certificate Expiration DateApril 4, 2028

Laboratory DirectorGloria Nansubuga

Laboratory Phone(253) 301-1875

Laboratory LocationShalom Adult Family Home 1 LLC1102 S 72nd St, Tacoma, WA 98408

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory to perform only waived tests.

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 Shalom Adult Family Home 1 LLC's NPI number?

The NPI number for Shalom Adult Family Home 1 LLC is 1477309607. It was assigned to this organization in the NPPES registry on April 29, 2024.

Where is Shalom Adult Family Home 1 LLC located?

Shalom Adult Family Home 1 LLC is located at 1102 S 72nd St, Tacoma, WA 98408. The listed phone number is (253) 301-1875.

What is Shalom Adult Family Home 1 LLC's specialty?

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

Does Shalom Adult Family Home 1 LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2320352) 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 Shalom Adult Family Home 1 LLC was last updated on April 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.