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General NPI Number Information
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NPI Number | 1942099460
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Entity Type | Organization
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Legal Business Name | SPRINGS GRAND PARK OPERATOR, LLC
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Dates
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Enumeration Date | 05/01/2025
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Last Update Date | 05/01/2025
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Provider Practice Location Address
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Address Line | 1221 28TH ST W
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City | BILLINGS
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State | MT
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Zip | 59102-3790
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Country | US
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Telephone | 406-652-6989
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Fax |
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Provider Business Mailing Address
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Address Line | 3330 SE THREE MILE LN
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City | MCMINNVILLE
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State | OR
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Zip | 97128-6232
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Country | US
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Telephone | 503-881-0344
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Fax |
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Authorized Official
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Title or Position | EVP
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Name | STEVEN STRADLEY
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Credential |
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Telephone | 503-435-2323
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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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