Grand Park LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1251 Issued in WA

Legal business name

GRAND PARK LLC

Practice address

242 St Helens Ave
Tacoma, WA 98402-2514

Phone

(253) 473-2842

NPI assigned

Aug 29, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Donald Hansen

Title

President

Phone

(253) 473-2842

Specialties & licenses 1

Addresses

Other identifiers 1

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

  • Adult Day Care Clinic/Center
  • Tacoma, WA
  • NPI 1033535117
  NPD tax ID

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1538569231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 ST HELENS AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984022514",
            "telephone_number": "253-627-3833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 ST HELENS AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984022514",
            "telephone_number": "253-473-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND PARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "DONALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "253-473-2842",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WA",
            "license": "1251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "921736",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret E Graham
• 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

• Assisted Living Facility in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Assisted Living Facility in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.