| NPI | 1811384423 |
|---|---|
| Doing Business As | PROVIDENCE ELDER AT HOME |
| Entity Type | Organization |
| Authorized Contact | MARK L METCALF Director Of Finance 503-215-5491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251B00000X Case Management |
| 261Q00000X | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2015-04-21 |