Organization
PRESTIGE RESIDENTIAL COMMUNITY LLC
Active
Other names
Elizabethan Manor
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY J VISLOCKY (MANAGING MEMBER)
(360) 735-7155
Entity
Organization
Contact information
Practice address
44882 MISSION RD, PENDLETON, OR 97801-9293
(541) 276-7157
(541) 276-3093
Mailing address
7700 NE PARKWAY DR, SUITE 300, VANCOUVER, WA 98662-6648
(360) 735-7155
(360) 735-9416
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
589713
—
OR
Enumeration date
02/27/2007
Last updated
08/22/2020
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