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General NPI Number Information
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NPI Number | 1205953007
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Entity Type | Organization
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Legal Business Name | WEST LINN SENIOR LIVING LLC
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Dates
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Enumeration Date | 03/25/2007
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 23000 HORIZON DR
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City | WEST LINN
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State | OR
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Zip | 97068-8247
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Country | US
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Telephone | 503-655-4373
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Fax | 503-485-1279
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Provider Business Mailing Address
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Address Line | PO BOX 3006
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City | SALEM
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State | OR
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Zip | 97302-0006
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Country | US
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Telephone | 503-375-9016
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Fax | 503-485-1279
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Authorized Official
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Title or Position | MANAGER
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Name | JON M HARDER
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Credential |
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Telephone | 503-375-9016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 1838630794
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License Number State | OR
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