Healthcare Provider Details

I. General information

NPI: 1932258563
Provider Name (Legal Business Name): CASCADE MANOR, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 11/20/2024
Certification Date: 11/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 W 30TH AVE
EUGENE OR
97405-3485
US

IV. Provider business mailing address

65 W. 30TH AVE.
EUGENE OR
97405-3373
US

V. Phone/Fax

Practice location:
  • Phone: 541-342-5901
  • Fax: 541-434-4250
Mailing address:
  • Phone: 541-342-5901
  • Fax: 541-434-4250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1221904933
License Number StateOR

VII. Legacy identifiers

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

VIII. Authorized Official

Name: ANTHONY SABATINI
Title or Position: COO
Credential:
Phone: 971-221-1425