Healthcare Provider Details

I. General information

NPI: 1083253421
Provider Name (Legal Business Name): HSRE-STELLAR II TRS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 01/02/2020
Certification Date: 01/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2956 152ND AVE NE
REDMOND WA
98052-5356
US

IV. Provider business mailing address

2825 E. COTTONWOOD PKWY SUITE 500
SALT LAKE CITY UT
84121-7060
US

V. Phone/Fax

Practice location:
  • Phone: 425-883-0495
  • Fax:
Mailing address:
  • Phone: 801-495-7500
  • Fax:

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: ADAM BENTON
Title or Position: MANAGER
Credential:
Phone: 801-495-7000