Organization
WILKINSON GEORGIA IDAHO SENIOR HOUSING LLC
Active
Other names
FOUR SEASONS ASSITED LIVING
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN HOLTZ (CONTROLLER)
(541) 747-3373
Entity
Organization
Contact information
Practice address
840 E DALTON AVE, COEUR D ALENE, ID 83815-9338
(208) 665-2100
(208) 665-9250
Mailing address
78 CENTENNIAL LOOP, EUGENE, OR 97401-7900
(541) 474-3373
(541) 746-5781
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
—
—
Other
Enumeration date
08/15/2007
Last updated
06/19/2008
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