Grand Park, LLC

Primary specialty

Adult Day Care Clinic/CenterTaxonomy code 261QA0600X

License

BH1251 Issued in WA

Legal business name

GRAND PARK, LLC

Practice address

246 St Helens Ave
Tacoma, WA 98402-2522

Phone

(253) 627-9990

Fax

(253) 680-1961

NPI assigned

Mar 12, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Janelle Ryan, MSW

Title

Program Administrator

Phone

(253) 627-9990

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Cascade Park Active Day Doing business as

Tax ID family

Cascade Park Active Day2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Grand Park LLC

  • Assisted Living Facility
  • Tacoma, WA
  • NPI 1538569231
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1033535117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 ST HELENS AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984022522",
            "telephone_number": "253-627-9990",
            "fax_number": "253-680-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 ST HELENS AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984022522",
            "telephone_number": "253-627-9990",
            "fax_number": "253-680-1961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND PARK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-12",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "JANELLE",
        "authorized_official_title_or_position": "PROGRAM ADMINISTRATOR",
        "authorized_official_telephone_number": "253-627-9990",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MSW"
    },
    "taxonomies": [
        {
            "code": "261QA0600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Day Care",
            "state": "WA",
            "license": "BH1251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "570343",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cascade Park Active Day",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Terry Lane Gram, PA-C
• Robert K. Gramenz, D.O.
• Joseph Gramling, M.D.
• Matthew Joseph Grammer, MD
• Grand Park LLC
• Francisca Tamayo Grande
• Colleen Ann Graney
• Grant Lundie MD PC
• Cornelia M Gerde Grant, M.A., PT
• David Wayne Grant Jr., D.O.

• Adult Day Care Clinic/Center in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Adult Day Care Clinic/Center in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.