Organization
MOSES LAKE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON HARDER (PRESIDENT)
(503) 485-4600
Entity
Organization
Contact information
Practice address
8425 ASPI BLVD, MOSES LAKE, WA 98837-3615
(509) 762-9115
(503) 485-1279
Mailing address
PO BOX 3006, SALEM, OR 97302-0006
(503) 485-4600
(503) 485-1279
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/25/2007
Last updated
08/22/2020
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