Grove Development Operations LLC

Key facts

NPI

1043088024

Entity type

Organization (NPI type 2)

Primary specialty

Assisted Living Facility 310400000X

Legal business name

GROVE DEVELOPMENT OPERATIONS LLC

Practice address

17996 Business 13
Reeds Spring, MO 65737-9663

Phone

(417) 272-6666

NPI assigned

Dec 19, 2023

Organization subpart

No

Authorized official

Name

Mr. Vance Earl Fager

Title

Owner

Phone

(208) 371-0158

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Wedgewood Gardens Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Dec 19, 2023.

{
    "created_epoch": "1702944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702944000000",
    "number": "1043088024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16404 NE 127TH ST",
            "city": "KEARNEY",
            "state": "MO",
            "postal_code": "640608969",
            "telephone_number": "208-371-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17996 BUSINESS 13",
            "city": "REEDS SPRING",
            "state": "MO",
            "postal_code": "657379663",
            "telephone_number": "417-272-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GROVE DEVELOPMENT OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-19",
        "last_updated": "2023-12-19",
        "certification_date": "2023-12-19",
        "status": "A",
        "authorized_official_last_name": "FAGER",
        "authorized_official_first_name": "VANCE",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-371-0158",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wedgewood Gardens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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