Organization
LAGRANDE ASSISTED LIVING LLC
Active
Other names
Wildflower Lodge
Organization subpart
No
Provider details
NPI number
Authorized official
JON M HARDER (MANAGER)
(503) 485-4600
Entity
Organization
Contact information
Practice address
508 16TH ST, LA GRANDE, OR 97850-4400
(541) 663-1200
(503) 485-1279
Mailing address
PO BOX 3006, SALEM, OR 97302-0006
(503) 375-9016
(503) 485-1279
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1621801256
OR
311500000X
Alzheimer Center (Dementia Center)
1419410824
OR
Other
Enumeration date
03/25/2007
Last updated
07/23/2008
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