Provider Demographics
NPI:1083253421
Name:HSRE-STELLAR II TRS, LLC
Entity Type:Organization
Organization Name:HSRE-STELLAR II TRS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BENTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-495-7000
Mailing Address - Street 1:2825 E. COTTONWOOD PKWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84121-7060
Mailing Address - Country:US
Mailing Address - Phone:801-495-7500
Mailing Address - Fax:
Practice Address - Street 1:2956 152ND AVE NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-5356
Practice Address - Country:US
Practice Address - Phone:425-883-0495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-02
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility