Provider Demographics
NPI:1720695927
Name:CHARDONNAY PROPERTY LLC
Entity Type:Organization
Organization Name:CHARDONNAY PROPERTY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HUTCHINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-308-3245
Mailing Address - Street 1:1045 CARRIAGE LN
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6751
Mailing Address - Country:US
Mailing Address - Phone:208-736-4808
Mailing Address - Fax:
Practice Address - Street 1:1045 CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6751
Practice Address - Country:US
Practice Address - Phone:208-736-4808
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility