Healthcare Provider Details

I. General information

NPI: 1962323097
Provider Name (Legal Business Name): LANE COUNTY BOUNTY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

909 E BEACON DR
EUGENE OR
97404-1109
US

IV. Provider business mailing address

909 E BEACON DR
EUGENE OR
97404-1109
US

V. Phone/Fax

Practice location:
  • Phone: 989-657-0536
  • Fax:
Mailing address:
  • Phone: 989-657-0536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: LAURIE KENSLER
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 989-657-0536