Provider Demographics
NPI:1902494610
Name:BFG SPOKANE PROPCO IV, LLC
Entity Type:Organization
Organization Name:BFG SPOKANE PROPCO IV, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF COMPLIANCE MGR
Authorized Official - Prefix:
Authorized Official - First Name:FAYE
Authorized Official - Middle Name:
Authorized Official - Last Name:GORDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-426-2756
Mailing Address - Street 1:506 N 40TH AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-4330
Mailing Address - Country:US
Mailing Address - Phone:509-426-2756
Mailing Address - Fax:509-426-2759
Practice Address - Street 1:4503 S FREYA ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-7135
Practice Address - Country:US
Practice Address - Phone:509-904-1245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility