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MOUNTAIN PALMS MANOR ADULT FAMILY HOME LLC
NPI 1801517842
Custodial Care Facility - Adult Care Home in University Place, WA

Active since September 08, 2022CLIA 50D2296223 · Waiver
5120 84TH AVE W, UNIVERSITY PLACE, WA 98467(803) 661-0208(253) 240-1976 Get Directions Write a Review

NPPES record last updated: September 8, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Mountain Palms Manor Adult Family Home Llc NPPES

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

MOUNTAIN PALMS MANOR ADULT FAMILY HOME LLC (NPI 1801517842) is a healthcare organization registered as an adult care home in University Place, Washington and active in the NPI registry since September 2022. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists David Kinyua, Owner, as its authorized official.

NPPES Registry Identity

NPI1801517842
Entity TypeOrganization
Primary Taxonomy311ZA0620X
Legal Business NameMOUNTAIN PALMS MANOR ADULT FAMILY HOME LLC
Location Address5120 84TH AVE WUniversity Place, WA 98467-1826
Mailing Address5120 84th Ave WUniversity Place, WA 98467-1826 · (803) 661-0208 · Fax (253) 240-1976
Phone(803) 661-0208
Fax(253) 240-1976
Organization SubpartNo
Authorized OfficialDavid KinyuaOwner · (803) 661-0208
Enumeration DateSeptember 8, 2022
NPPES CertifiedSeptember 8, 2022
✔ NPI 1801517842 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.
5120 84TH AVE W, University Place, WA 98467
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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 50D2296223

Mountain Palms Manor Adult Family Home LLC · University Place, WA
Active · expires Apr 4, 2028
CLIA Number50D2296223
Laboratory TypeAfh
Certificate Effective DateDecember 22, 2023
Certificate Expiration DateApril 4, 2028
Laboratory DirectorDavid Kinyna
Laboratory Phone(803) 661-0208
Laboratory LocationMountain Palms Manor Adult Family Home LLC5120 84th Ave W, University Place, WA 98467
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 2

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

JACQUELINE NGANGA RN
Registered Nurse
5120 84TH AVE W
UNIVERSITY PLACE, WA 98467
Pierce County (978) 677-4931
MR. DAVID KINYUA
Licensed Practical Nurse
5120 84TH AVE W
UNIVERSITY PLACE, WA 98467
Pierce County (951) 333-9701

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 Mountain Palms Manor Adult Family Home LLC's NPI number?

The NPI number for Mountain Palms Manor Adult Family Home LLC is 1801517842. It was assigned to this organization in the NPPES registry on September 8, 2022.

Where is Mountain Palms Manor Adult Family Home LLC located?

Mountain Palms Manor Adult Family Home LLC is located at 5120 84th Ave W, University Place, WA 98467. The listed phone number is (803) 661-0208.

What is Mountain Palms Manor Adult Family 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 Mountain Palms Manor Adult Family Home LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2296223) 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 Mountain Palms Manor Adult Family Home LLC was last updated on September 8, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.