Prairie Manor
NPI #1164844866 in Wilsonville, Oregon
Provider Information
- NPI Number
- 1164844866
- Entity Type
- Organization
- Organization Name
- Prairie Manor
- Subpart
- Yes (part of a larger organization)
- Parent Organization
- YES
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jan 15, 2014
- Last Updated
- Jan 15, 2014
Practice Location
- Address
- 25117 SW PARKWAY AVE
- Address 2
- SUITE D
- City
- Wilsonville
- State
- Oregon
- ZIP Code
- 97070-9697
- Phone
- (708) 754-7601
Authorized Official
- Name
- MRS. ROSEMARIE M SMITH, COTA/L
- Title
- CERTIFIED OCCUPATIONAL THERAPY ASSI
- Phone
- (708) 474-3116
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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