Healthcare Provider Details

I. General information

NPI: 1255206744
Provider Name (Legal Business Name): SENIORS AT HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2025
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19704 HOLLYGRAPE ST
BEND OR
97702-2571
US

IV. Provider business mailing address

19704 HOLLYGRAPE ST
BEND OR
97702-2571
US

V. Phone/Fax

Practice location:
  • Phone: 541-550-1246
  • Fax:
Mailing address:
  • Phone: 541-550-1246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINA LYNN RHYNE
Title or Position: SOLE MEMBER
Credential:
Phone: 541-550-1246