Provider Demographics
NPI:1942099460
Name:SPRINGS GRAND PARK OPERATOR, LLC
Entity type:Organization
Organization Name:SPRINGS GRAND PARK OPERATOR, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:STRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-435-2323
Mailing Address - Street 1:3330 SE THREE MILE LN
Mailing Address - Street 2:
Mailing Address - City:MCMINNVILLE
Mailing Address - State:OR
Mailing Address - Zip Code:97128-6232
Mailing Address - Country:US
Mailing Address - Phone:503-881-0344
Mailing Address - Fax:
Practice Address - Street 1:1221 28TH ST W
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3790
Practice Address - Country:US
Practice Address - Phone:406-652-6989
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility