Provider Demographics
NPI:1477329530
Name:SMILING SPRINGS CARE LLC
Entity type:Organization
Organization Name:SMILING SPRINGS CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUK
Authorized Official - Middle Name:E
Authorized Official - Last Name:SAHILU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-208-6772
Mailing Address - Street 1:1657 SE PELTON CT
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-2930
Mailing Address - Country:US
Mailing Address - Phone:503-208-6772
Mailing Address - Fax:
Practice Address - Street 1:1657 SE PELTON CT
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-2930
Practice Address - Country:US
Practice Address - Phone:503-208-6772
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities