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General NPI Number Information
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NPI Number | 1790218386
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Entity Type | Organization
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Legal Business Name | BATTLEGROUND OF CASCADIA LLC
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Dates
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Enumeration Date | 04/10/2017
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Last Update Date | 05/24/2024
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Provider Practice Location Address
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Address Line | 510 N PARKWAY AVE
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City | BATTLE GROUND
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State | WA
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Zip | 98604-8004
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Country | US
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Telephone | 360-687-5141
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Fax |
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Provider Business Mailing Address
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Address Line | 408 S EAGLE RD SUITE 205
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City | EAGLE
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State | ID
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Zip | 83616-6078
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Country | US
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Telephone | 208-401-9600
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | OWEN HAMMOND
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Credential |
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Telephone | 208-401-9600
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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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