Healthcare Provider Details

I. General information

NPI: 1053852327
Provider Name (Legal Business Name): VALLEY WEST OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 03/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 WARREN ST
EUGENE OR
97405-1116
US

IV. Provider business mailing address

3001 KEITH ST NW
CLEVELAND TN
37312-3713
US

V. Phone/Fax

Practice location:
  • Phone: 541-686-2828
  • Fax: 541-485-6006
Mailing address:
  • Phone: 423-473-5751
  • Fax: 423-339-8344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: CINDY CROSS
Title or Position: ASSISTANT SECRETARY
Credential:
Phone: 423-473-5867