# JACKSON HOLE SENIOR LIVING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** River Rock Lodge Assisted Living Community
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184811143
- **Authorized official:** MR. JON M HARDER (MANAGER)
- **Authorized official phone:** (503) 375-9016

## Contact information

- **Practice address:** 3000 W BIG TRAIL DR, JACKSON HOLE, WY 83001-9138
- **Practice address phone:** (307) 734-0500
- **Mailing address:** 3723 FAIRVIEW INDUSTRIAL DR SE, SALEM, OR 97302-1177
- **Mailing address phone:** (503) 375-9016

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | 08-035 | WY | Yes |

## Other

- **Enumeration date:** 10/03/2007
- **Last updated:** 10/03/2007