Provider Demographics
NPI:1760727184
Name:RICHLAND ALF VENTURES, LLC
Entity Type:Organization
Organization Name:RICHLAND ALF VENTURES, LLC
Other - Org Name:PRESTIGE ASSISTED LIVING AT RICHLAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EX V.P. OF FINANCE / PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:VISLOCKY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-735-7155
Mailing Address - Street 1:7700 NE PARKWAY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98662-6648
Mailing Address - Country:US
Mailing Address - Phone:360-735-7155
Mailing Address - Fax:360-735-9416
Practice Address - Street 1:1745 PIKE AVE
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99354-2295
Practice Address - Country:US
Practice Address - Phone:509-946-8095
Practice Address - Fax:509-946-4160
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2150310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility