Provider Demographics
NPI:1790934933
Name:SPRING SENIOR ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:SPRING SENIOR ASSISTED LIVING, LLC
Other - Org Name:SPRING SENIOR ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-468-4752
Mailing Address - Street 1:20900 EARL ST
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4309
Mailing Address - Country:US
Mailing Address - Phone:310-370-3594
Mailing Address - Fax:310-214-3684
Practice Address - Street 1:20900 EARL ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4309
Practice Address - Country:US
Practice Address - Phone:310-370-3594
Practice Address - Fax:310-214-3684
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-11
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA198204079310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility