Jefferson Manor

LBN: Jefferson Manor Residential Care, Llc
Jefferson Manor is an health care organization with primary practice located at 664 Se Jefferson St , Dallas OR 97338-2024. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center), which is considered as the primary health care specialty. Jefferson Manor Residential Care, Llc can be contacted via phone (503) 623-8104, or through Moss, Elizabeth Marie via phone (503) 588-2725.

Contact Information

Primary practice address
664 Se Jefferson St Dallas OR 97338-2024
Phone: (503) 623-8104
Fax: (503) 623-0772
Website:
Map and Directions
Authorized official contact:
Name: Moss, Elizabeth Marie
Phone: (503) 588-2725

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Alzheimer Center (Dementia Center) 311500000X 1087658107 Oregon

Profile Details

NPI number 1669633707
LBN Legal business name Jefferson Manor Residential Care, Llc
DBA Doing business as Jefferson Manor
Authorized official Moss, Elizabeth Marie
Entity Organization
Organization subpart 1 No
Enumeration date Jun 20th, 2008
Last updated Jun 20th, 2008 - about 16 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669633707 NPPES
Oregon MEDICAID 515448

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