GENTOG, LLC
Custodial Care Facility
Tigard, Oregon
Provider NPI: 1508170945
Organization Information:Organization Name: GENTOG, LLC
Practice Location:
11535 SW DURHAM RD SUITE C5 TIGARD, OR 97224 US
Tel: 503-639-2600 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Other Provider Identifiers:
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin
Practice Location:
11535 SW DURHAM RD SUITE C5 TIGARD, OR 97224 US
Tel: 503-639-2600 Fax: --
Business Mailing Address:
,
Tel: -- Fax: --
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
Y | 311Z00000X | Nursing & Custodial Care Facilities Custodial Care Facility | OR |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
699816 | OR | 05 |
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin