Healthcare Provider Details

I. General information

NPI: 1609404664
Provider Name (Legal Business Name): MERRILL GARDENS L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 03/27/2020
Certification Date: 03/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 N RIVER RD
LEE NH
03861-6214
US

IV. Provider business mailing address

1938 FAIRVIEW AVE E STE 300
SEATTLE WA
98102-3650
US

V. Phone/Fax

Practice location:
  • Phone: 603-659-6586
  • Fax:
Mailing address:
  • Phone: 206-676-5300
  • Fax: 206-676-5353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: DOUG D. SPEAR
Title or Position: EVP AND CFO
Credential:
Phone: 206-676-5300