Organization
GENGREENMOUNTAIN LLC
Active
Organization
GENGREENMOUNTAIN LLC
Active
Other names
Montage Ridge
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA STAYNER (DIRECTOR OF COMPLIANCE)
(503) 594-2263
Entity
Organization
Contact information
Practice address
12791 W ALAMEDA PKWY, LAKEWOOD, CO 80228-2838
(503) 652-0750
Mailing address
8440 SE SUNNYBROOK BLVD STE 100, CLACKAMAS, OR 97015-5781
(503) 652-0750
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
314000000X
Skilled Nursing Facility
—
—
Other
Enumeration date
10/11/2019
Last updated
11/15/2023
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