Organization
KELSO AL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHRIS SPENCER (SR. VICE PRESIDENT OF OPERATIONS)
(332) 322-1990
Entity
Organization
Contact information
Practice address
114 CORDUROY RD, KELSO, WA 98626-5341
(360) 469-5060
Mailing address
600 3RD AVE FL 21, NEW YORK, NY 10016-1916
(332) 322-1990
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2731
DEPARTMENT OF SOCIAL AND HEALTH SERVICES
WA
Enumeration date
06/15/2026
Last updated
06/15/2026
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