Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Pine Grove Senior Living LLC

Organization Assisted Living Facility · NPI 1245059864

Pine Grove Senior Living LLC is an Assisted Living Facility in Green Bay, Wisconsin. Registered with an NPI since 2024.

In the registry since
2024
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1006 N Military Ave
Green Bay, WI 54303-4412
Phone: (920) 499-1119
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Assisted Living Facility (primary) Taxonomy 310400000X

Record details

NPI number1245059864
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Amber Tueller — Secretary · (208) 207-2726
Other names Blue Jay Springs Senior Living And Memory Care
NPI enumeratedOctober 9, 2024
Last updated in NPPESNovember 19, 2025
Certification dateNovember 19, 2025
Mailing address1006 N Military Ave, Green Bay, WI 54303-4412

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