Organization
HIGH DESERT ASSISTED LIVING COMMUNITY LLC
Active
Other names
High Desert Assisted Living Community
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLEY D HAMILTON (CEO-PRES OF MANAGER)
(503) 566-5715
Entity
Organization
Contact information
Practice address
3220 STATE ST, SUITE 200, SALEM, OR 97301-6872
(506) 566-5715
(503) 588-3531
Mailing address
2660 NE MARY ROSE PL, BEND, OR 97701-5522
(541) 312-2003
(541) 312-2011
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
087735-90
REGISTRY #
OR
Enumeration date
05/07/2007
Last updated
10/04/2007
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