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General NPI Number Information
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NPI Number | 1265600720
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Entity Type | Organization
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Legal Business Name | WILLAMETTE VALLEY HOME CARE, INC.
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Dates
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Enumeration Date | 02/18/2008
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Last Update Date | 10/26/2015
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Provider Practice Location Address
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Address Line | 250 BROADALBIN ST SW STE 230
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City | ALBANY
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State | OR
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Zip | 97321-2495
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Country | US
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Telephone | 541-928-2061
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Fax |
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Provider Business Mailing Address
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Address Line | 250 BROADALBIN ST SW STE 250
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City | ALBANY
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State | OR
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Zip | 97321-2495
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MARK WANG
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Credential |
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Telephone | 541-928-2061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 15-2100
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License Number State | OR
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