Provider Demographics
NPI:1851562664
Name:BUTTE PARK ROYAL OPERATIONS, LLC
Entity Type:Organization
Organization Name:BUTTE PARK ROYAL OPERATIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:R
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:925-362-0354
Mailing Address - Street 1:2 CROW CANYON CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1953
Mailing Address - Country:US
Mailing Address - Phone:925-362-0354
Mailing Address - Fax:925-362-8470
Practice Address - Street 1:3251 NETTIE ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-6531
Practice Address - Country:US
Practice Address - Phone:406-723-3225
Practice Address - Fax:406-723-6470
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility