Provider Demographics
NPI:1417515305
Name:TAPESTRY SPRINGBORO SENIOR HOUSING MANAGEMENT, LLC
Entity Type:Organization
Organization Name:TAPESTRY SPRINGBORO SENIOR HOUSING MANAGEMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF CLINICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:PAWLINA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:952-854-8800
Mailing Address - Street 1:2001 KILLEBREW DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-1884
Mailing Address - Country:US
Mailing Address - Phone:952-854-8800
Mailing Address - Fax:
Practice Address - Street 1:8683 CLEARCREEK FRANKLIN RD.
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066
Practice Address - Country:US
Practice Address - Phone:937-748-9344
Practice Address - Fax:937-748-9077
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility