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HAZEL DELL VENTURES LLC NPI 1447387626


NPI Information

NPI: 1447387626
Provider Name: HAZEL DELL VENTURES LLC

Doing Business As: PRESTIGE ASSISTED LIVING AT HAZEL DELL

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
7514 NE 13TH AVE
VANCOUVER, WA
ZIP 98665
Phone: (360) 693-2402
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HAZEL DELL VENTURES LLC is an assisted living facility in Vancouver, WA. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. HAZEL DELL VENTURES LLC NPI is 1447387626. The provider is registered as an organization entity type.
The provider Is Doing Business As Prestige Assisted Living At Hazel Dell.

The provider's business location address is:

7514 NE 13TH AVE
VANCOUVER, WA
ZIP 98665-458
Phone: (360) 693-2402
Fax: (360) 693-5011

The provider's authorized official is Gregory J Vislocky .
The authorized official title is Managing Member and has the following contact phone number (360) 735-7155.

The enumeration date for this NPI number is 2/27/2007 and was last updated on 8/22/2020.


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
1310400000XAssisted Living FacilityBH 1615WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1995961MEDICAIDWASHINGTON

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: 11/14/2023

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