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General NPI Number Information
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NPI Number | 1174237432
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Entity Type | Organization
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Legal Business Name | FOUNTAIN SPRINGS SNF OPERATIONS, LLC
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Dates
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Enumeration Date | 01/11/2023
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 2000 WESLEYAN BLVD
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City | RAPID CITY
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State | SD
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Zip | 57702-9340
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Country | US
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Telephone | 605-343-3555
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Fax | 605-721-1457
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Provider Business Mailing Address
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Address Line | 4601 NE 77TH AVE STE 300
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City | VANCOUVER
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State | WA
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Zip | 98662-6736
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Country | US
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Telephone | 360-837-0400
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Fax | 360-967-0022
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | YITZCHOK YENOWITZ
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Credential |
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Telephone | 732-769-8877
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 227900000X
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Taxonomy Name | Registered Respiratory Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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