Healthcare Provider Details

I. General information

NPI: 1225850399
Provider Name (Legal Business Name): CP BENEDICTINE OR HH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/29/2024
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

570 S MAIN ST
MOUNT ANGEL OR
97362-9540
US

IV. Provider business mailing address

570 S MAIN ST
MOUNT ANGEL OR
97362-9540
US

V. Phone/Fax

Practice location:
  • Phone: 503-845-9226
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
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: TERRI WARREN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 310-480-2982