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PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY LLC NPI 1275746414


NPI Information

NPI: 1275746414
Provider Name: PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY LLC

Doing Business As: PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY

Classification: Point of Service - 305S00000X
Entity Type: Organization

CLIA Number: 50D2254859

Address:
3220 STATE ST
SUITE 200
SALEM, OR
ZIP 97301
Phone: (506) 566-5715
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PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY LLC is a point of service in Salem, OR. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. PARK VISTA RETIREMENT & ASSISTED LIVING COMMUNITY LLC NPI is 1275746414. The provider is registered as an organization entity type.
The provider Is Doing Business As Park Vista Retirement & Assisted Living Community.

The provider's business location address is:

3220 STATE ST
SUITE 200
SALEM, OR
ZIP 97301-872
Phone: (506) 566-5715
Fax: (503) 588-3531

The provider's authorized official is Kelley D Hamilton .
The authorized official title is Ceo-pres Of Manager and has the following contact phone number (506) 566-5715.

The CLIA number assigned to this NPI record is 50D2254859 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/7/2007 and was last updated on 10/4/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305S00000XPoint of Service1810WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.