# PARK PLACE SPARTANBURG

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487875514
- **Authorized official:** JON HARDER (CEO PRESIDENT)
- **Authorized official phone:** (503) 485-8697

## Contact information

- **Practice address:** 2720 COUNTRY CLUD ROAD, SPARTANBURG, SC 29302
- **Practice address phone:** (864) 591-1116
- **Practice address fax:** (503) 485-1279
- **Mailing address:** PO BOX 3006, SALEM, OR 97302
- **Mailing address phone:** (503) 485-8697
- **Mailing address fax:** (503) 485-1279

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 05/02/2007
- **Last updated:** 08/22/2020