Organization
FIVE RIVERS ASSISTED LIVING AND RETIREMENT COMMMUNITY, LLC
Active
Other names
Five Reivers Assisted Living & Retirement Community
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KELLEY D HAMILTON (CEO-PRES OF MANAGER)
(503) 566-5715
Entity
Organization
Contact information
Practice address
3200 STATE STREET, SUITE 200, SALEM, OR 97301
(503) 566-5715
(503) 588-3531
Mailing address
3500 12TH ST, TILLAMOOK, OR 97141-2637
(503) 842-0918
(503) 842-7077
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000394-95
REGISTRY #
OR
Enumeration date
05/09/2007
Last updated
10/04/2007
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