=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598554008
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SPRINGS BUTTE OPERATOR, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/01/2025
-----------------------------------------------------
Last Update Date | 05/01/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 MOUNT HIGHLAND DR
-----------------------------------------------------
City | BUTTE
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59701-4080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-494-0083
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3330 SE THREE MILE LN
-----------------------------------------------------
City | MCMINNVILLE
-----------------------------------------------------
State | OR
-----------------------------------------------------
Zip | 97128-6232
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 503-435-2323
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | EVP
-----------------------------------------------------
Name | STEVEN STRADLEY
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 503-435-2332
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------