Organization
LSREF GOLDEN OPS 26 (WA), LLC
Active
Other names
Orchard Pointe Senior Alzheimer Community
Organization subpart
No
Provider details
NPI number
Authorized official
WICK PETERSON (EXECUTIVE VICE PRESIDENT)
(858) 775-5857
Entity
Organization
Contact information
Practice address
300 S KITSAP BLVD, PORT ORCHARD, WA 98366-3778
(360) 874-7400
(360) 874-1969
Mailing address
500 STEVENS AVE, SUITE 100, SOLANA BEACH, CA 92075-2055
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
315196
—
WA
Enumeration date
06/22/2009
Last updated
06/22/2009
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