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JEFFERSON MANOR RESIDENTIAL CARE, LLC

Alzheimer Center

Dallas, Oregon

Provider NPI: 1669633707

Organization Information:
Organization Name:  JEFFERSON MANOR RESIDENTIAL CARE, LLC


Practice Location:
664 SE JEFFERSON ST  DALLAS, OR 97338 US
Tel: 503-623-8104  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311500000XNursing & Custodial Care Facilities
Alzheimer Center (Dementia Center)
OR1087658107

Other Provider Identifiers:

IssuerNumberStateType
515448OR05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




ALZHEIMERS JOBS OR - Page 1



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