Organization
BEAVERTON HILLS ASSISTED LIVING RESIDENCE, LLC
Active
Other names
Beaverton Hills Assisted Living Residence
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLEY D HAMILTON (CEO-PRESIDENT OF MANAGER)
(503) 566-5715
Entity
Organization
Contact information
Practice address
3220 STATE ST, SUITE 200, SALEM, OR 97301-6872
(503) 566-5715
(506) 588-3531
Mailing address
4525 SW 99TH AVE, BEAVERTON, OR 97005-3342
(503) 520-1350
(503) 671-0511
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72220586
REGISTRY #
OR
Enumeration date
05/04/2007
Last updated
10/04/2007
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