Organization
PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY LLC
Active
Other names
Park Vista Retirement & Assisted Living Community
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLEY D HAMILTON (CEO-PRES OF MANAGER)
(506) 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
2944 SE LUND AVE, PORT ORCHARD, WA 98366-5547
(360) 871-2323
(360) 871-2521
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
1810
WA
Other
Enumeration date
05/07/2007
Last updated
10/04/2007
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