Healthcare Provider Details

I. General information

NPI: 1275438467
Provider Name (Legal Business Name): DOUGLAS FIR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

329 DEAN AVE
EUGENE OR
97404-1316
US

IV. Provider business mailing address

329 DEAN AVE
EUGENE OR
97404-1316
US

V. Phone/Fax

Practice location:
  • Phone: 571-741-4241
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number StateNULL

VIII. Authorized Official

Name: DAGMAWI TADESSE MESFIN
Title or Position: ADMINITRATOR
Credential:
Phone: 571-741-4241