Jefferson Manor Residential Care, LLC

NPI #1669633707 in Dallas, Oregon

Provider Information

NPI Number
1669633707
Entity Type
Organization
Organization Name
Jefferson Manor Residential Care, LLC
Primary Specialty
Alzheimer Center (Dementia Center)
Enumeration Date
Jun 20, 2008
Last Updated
Jun 20, 2008

Practice Location

Address
664 SE JEFFERSON ST
City
Dallas
State
Oregon
ZIP Code
97338-2024
Phone
(503) 623-8104

Authorized Official

Name
ELIZABETH MARIE MOSS
Title
DIRECTOR OF RISK MANAGEMENT
Phone
(503) 588-2725

Specialties & Taxonomy Codes

Specialty
Alzheimer Center (Dementia Center)

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