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
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