NPI 1013120393

Roseburg Assisted Living LLC

Organisation Point of Service Salem, OR

Practice location

Address: 3220 State St Suite 200, Salem, OR 97301-6872
Phone: (503) 566-5715
Mailing address: 1400 NE Rocky Ridge Dr, Roseburg, OR 97470-5673

Authorised official

Name: Kelley D Hamilton
Title: Ceo-Pres of Manager
Phone: (503) 566-5715

Registered specialties

Point of Service Primary

Managed Care Organizations Taxonomy 305S00000X

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Registry record

NPI: 1013120393
Entity type: Organization
NPI issued: 7 May 2007
Record last updated: 4 Oct 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.