Provider Demographics
NPI:1497461750
Name:PILLARS OF GRAND RAPIDS LLC
Entity Type:Organization
Organization Name:PILLARS OF GRAND RAPIDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:HALEY
Authorized Official - Middle Name:
Authorized Official - Last Name:HJORT
Authorized Official - Suffix:
Authorized Official - Credentials:LALD
Authorized Official - Phone:218-999-4950
Mailing Address - Street 1:2060 SW 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55744-4396
Mailing Address - Country:US
Mailing Address - Phone:218-999-4999
Mailing Address - Fax:
Practice Address - Street 1:2060 SW 8TH ST
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55744-4396
Practice Address - Country:US
Practice Address - Phone:218-999-4999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility