PINE GROVE SENIOR LIVING LLC
NPI 1245059864
Assisted Living Facility in Green Bay, WI

Q: What is Pine Grove Senior Living LLC's NPI number?

The NPI number for Pine Grove Senior Living LLC is 1245059864. It was assigned to this organization in the NPPES registry on October 9, 2024. The provider is doing business as Blue Jay Springs Senior Living and Memory Care.

Q: What is Pine Grove Senior Living LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

Active since October 09, 2024

1006 N MILITARY AVE, GREEN BAY, WI 54303(920) 499-1119 Get Directions Write a Review

NPPES record last updated: November 19, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 19, 2025, Jun 12, 2025, Oct 9, 2024 (3 updates tracked since 2024).

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About Pine Grove Senior Living Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PINE GROVE SENIOR LIVING LLC (NPI 1245059864), doing business as Blue Jay Springs Senior Living And Memory Care, is a healthcare organization registered as an assisted living facility in Green Bay, Wisconsin and active in the NPI registry since October 2024. The organization lists Amber Tueller, Secretary, as its authorized official.

NPPES Registry Identity

NPI1245059864

Entity TypeOrganization

Primary Taxonomy310400000X

Legal Business NamePINE GROVE SENIOR LIVING LLC

Location Address1006 N MILITARY AVEGreen Bay, WI 54303-4412

Mailing Address1006 N Military AveGreen Bay, WI 54303-4412 · (543) 032-0840

Phone(920) 499-1119

Organization SubpartNo

Authorized OfficialAmber TuellerSecretary · (208) 207-2726

Enumeration DateOctober 9, 2024

Last NPPES UpdateNovember 19, 20253 updates tracked since enumeration

NPPES CertifiedNovember 19, 2025

✔ NPI 1245059864 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAssisted Living FacilityNursing & Custodial Care Facilities

Taxonomy Code310400000X

Definition

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.

1006 N MILITARY AVE, Green Bay, WI 54303

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Other Names 1

Doing Business AsBlue Jay Springs Senior Living And Memory Care

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARLA VISTA MANOR ASSISTED LIVING OF GREEN BAY, LLC

Assisted Living Facility

1006 N MILITARY AVE
GREEN BAY, WI 54303

Brown County (920) 499-1119

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Pine Grove Senior Living LLC's NPI number?

The NPI number for Pine Grove Senior Living LLC is 1245059864. It was assigned to this organization in the NPPES registry on October 9, 2024. The provider is doing business as Blue Jay Springs Senior Living and Memory Care.

Where is Pine Grove Senior Living LLC located?

Pine Grove Senior Living LLC is located at 1006 N Military Ave, Green Bay, WI 54303. The listed phone number is (920) 499-1119.

What is Pine Grove Senior Living LLC's specialty?

The primary specialty registered for this NPI is Assisted Living Facility with taxonomy code 310400000X.

When was this NPI record last updated?

The NPPES record for Pine Grove Senior Living LLC was last updated on November 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.