Organization
HAZEL DELL VENTURES LLC
Active
Other names
Prestige Assisted Living at Hazel Dell
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY J VISLOCKY (MANAGING MEMBER)
(360) 735-7155
Entity
Organization
Contact information
Practice address
7514 NE 13TH AVE, VANCOUVER, WA 98665-0458
(360) 693-2402
(360) 693-5011
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
BH 1615
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
995961
—
WA
Enumeration date
02/27/2007
Last updated
08/22/2020
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