Beaver Creek Ops, LLC
NPI #1275984049 in Brown Deer, Wisconsin
Provider Information
- NPI Number
- 1275984049
- Entity Type
- Organization
- Organization Name
- Beaver Creek Ops, LLC
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Jun 23, 2016
- Last Updated
- Jun 23, 2016
Practice Location
- Address
- 8875 N 60TH ST
- City
- Brown Deer
- State
- Wisconsin
- ZIP Code
- 53223-2269
- Phone
- (952) 746-3630
Authorized Official
- Name
- RYAN NOVACZYK
- Title
- PRESIDENT/CFO
- Phone
- (612) 840-3924
Specialties & Taxonomy Codes
| Specialty |
|---|
| Assisted Living Facility |
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