Organization
PARK PLACE ASSISTED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JON M HARDER (MANAGER)
(503) 485-4600
Entity
Organization
Contact information
Practice address
1930 E 12TH ST, CASPER, WY 82601-4075
(307) 265-2273
(503) 485-1279
Mailing address
3723 FAIRVIEW INDUSTRIAL DR SE, SUITE 270, SALEM, OR 97302-1177
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
03/13/2007
Last updated
08/22/2020
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