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General NPI Number Information
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NPI Number | 1720943434
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Entity Type | Organization
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Legal Business Name | SAND HOLLOW, LLC
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Dates
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Enumeration Date | 12/16/2025
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Last Update Date | 12/16/2025
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Provider Practice Location Address
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Address Line | 175 NE 16TH ST
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City | MADRAS
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State | OR
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Zip | 97741-2219
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Country | US
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Telephone | 541-475-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 599 MENLO DR STE 200
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City | ROCKLIN
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State | CA
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Zip | 95765-3725
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | RYAN WILLIAMS
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Credential |
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Telephone | 916-299-7030
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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