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General NPI Number Information
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NPI Number | 1588479042
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Entity Type | Organization
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Legal Business Name | GARDEN CITY MC LLC
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Dates
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Enumeration Date | 02/11/2025
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Last Update Date | 06/25/2025
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Provider Practice Location Address
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Address Line | 8250 W MARIGOLD ST
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City | GARDEN CITY
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State | ID
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Zip | 83714-1354
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Country | US
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Telephone | 208-856-7231
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Fax |
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Provider Business Mailing Address
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Address Line | 650 HAWTHORNE AVE SE STE 210
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City | SALEM
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State | OR
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Zip | 97301-5895
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Country | US
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Telephone | 503-391-9999
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Fax |
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Authorized Official
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Title or Position | ACCOUNTS RECEIVABLE MANAGER
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Name | JANUARY E ZEEB
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Credential |
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Telephone | 503-856-5975
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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