Provider Demographics
NPI:1609916170
Name:LANE COUNTY SENIOR LIVING FOUNDATION
Entity Type:Organization
Organization Name:LANE COUNTY SENIOR LIVING FOUNDATION
Other - Org Name:DIAMOND VIEW ESTATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHIRLEY
Authorized Official - Middle Name:MAXINE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-397-5111
Mailing Address - Street 1:775 DIAMOND VIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:DIGHTON
Mailing Address - State:KS
Mailing Address - Zip Code:67839-5076
Mailing Address - Country:US
Mailing Address - Phone:620-397-5111
Mailing Address - Fax:620-397-5112
Practice Address - Street 1:775 DIAMOND VIEW DRIVE
Practice Address - Street 2:
Practice Address - City:DIGHTON
Practice Address - State:KS
Practice Address - Zip Code:67839-5076
Practice Address - Country:US
Practice Address - Phone:620-397-5111
Practice Address - Fax:620-397-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSN051001310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility