Organization
GRANGEVILLE OF CASCADIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OWEN C HAMMOND (PRESIDENT)
(208) 401-9600
Entity
Organization
Contact information
Practice address
410 E NORTH 2ND ST, GRANGEVILLE, ID 83530-2258
(208) 983-1131
Mailing address
2205 E RIVERSIDE DR STE 100, EAGLE, ID 83616-7621
(208) 401-9600
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/08/2021
Last updated
05/24/2024
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