# PARK PLACE ASSISTED LIVING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467585034
- **Authorized official:** JON M HARDER (MANAGER)
- **Authorized official phone:** (503) 485-4600

## Contact information

- **Practice address:** 1930 E 12TH ST, CASPER, WY 82601-4075
- **Practice address phone:** (307) 265-2273
- **Practice address fax:** (503) 485-1279
- **Mailing address:** 3723 FAIRVIEW INDUSTRIAL DR SE, SUITE 270, SALEM, OR 97302-1177

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 310400000X | Assisted Living Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 08/22/2020