Healthcare Provider Details

I. General information

NPI: 1144930009
Provider Name (Legal Business Name): EUGENE OF CASCADIA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2022
Last Update Date: 05/24/2024
Certification Date: 05/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 HILYARD ST
EUGENE OR
97405-3867
US

IV. Provider business mailing address

2205 E RIVERSIDE DR STE 100
EAGLE ID
83616-7621
US

V. Phone/Fax

Practice location:
  • Phone: 208-401-9600
  • Fax: 208-314-0639
Mailing address:
  • Phone: 208-401-9600
  • Fax: 208-314-0639

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: OWEN HAMMOND
Title or Position: PRESIDENT
Credential:
Phone: 208-401-9600