Organization
PHOENIX SENIOR LIVING LLC
Active
Organization
PHOENIX SENIOR LIVING LLC
Active
Other names
Willow Creek Assisted Living & Memory Care Community
Organization subpart
No
Provider details
NPI number
Authorized official
JON M HARDER (MANAGER)
(503) 485-8697
Entity
Organization
Contact information
Practice address
12322 N 13TH AVENUE, YOUNGTOWN, AZ 85363
(623) 583-2460
(503) 485-1279
Mailing address
PO BOX 3006, SALEM, OR 97302-0006
(503) 485-8697
(503) 485-1279
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
ALC5613
AZ
311500000X
Alzheimer Center (Dementia Center)
ALC5613
AZ
Other
Enumeration date
04/27/2007
Last updated
07/23/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up