Healthcare Provider Details

I. General information

NPI: 1124951256
Provider Name (Legal Business Name): NEW OUTLOOK HOME CARE OF CENTRAL OREGON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 SW HIGHLAND AVE
REDMOND OR
97756-2639
US

IV. Provider business mailing address

1241 SW HIGHLAND AVE
REDMOND OR
97756-2639
US

V. Phone/Fax

Practice location:
  • Phone: 574-849-1174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JEREMY MAST
Title or Position: CO-OWNER
Credential:
Phone: 574-849-1174