Provider Demographics
NPI:1750040093
Name:WESTLAKE ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:WESTLAKE ASSISTED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:TOD
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-599-3459
Mailing Address - Street 1:1914 WILLAMETTE FALLS DR STE 230
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4689
Mailing Address - Country:US
Mailing Address - Phone:480-599-3459
Mailing Address - Fax:
Practice Address - Street 1:3151 W 20TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-6554
Practice Address - Country:US
Practice Address - Phone:970-346-1222
Practice Address - Fax:970-346-1228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-14
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility