| NPI | 1164525077 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD DOANE SNOW Administrator 503-236-2624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2020-08-22 |