| NPI | 1952667669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA LEE WALDROFF Manager Managed, Managing Member 503-706-0878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility |
| Enumeration Date | 2012-04-06 |
| Last Update Date | 2012-04-06 |