Organization
GRAND PARK LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONALD HANSEN (PRESIDENT)
(253) 473-2842
Entity
Organization
Contact information
Practice address
242 ST HELENS AVE, TACOMA, WA 98402-2514
(253) 473-2842
Mailing address
242 ST HELENS AVE, TACOMA, WA 98402-2514
(253) 627-3833
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1251
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
921736
—
WA
Enumeration date
08/29/2014
Last updated
08/29/2014
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