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General NPI Number Information
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NPI Number | 1376851352
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Entity Type | Organization
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Legal Business Name | COURTNEY FAMILY ENTERPRISES INCORPERATED
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Dates
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Enumeration Date | 09/23/2010
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Last Update Date | 09/23/2010
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Provider Practice Location Address
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Address Line | 202 NE KELLY AVE
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City | GRESHAM
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State | OR
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Zip | 97030-7544
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Country | US
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Telephone | 503-661-0600
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Fax | 503-661-0677
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Provider Business Mailing Address
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Address Line | 202 NE KELLY AVE
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City | GRESHAM
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State | OR
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Zip | 97030-7544
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Country | US
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Telephone | 503-661-0600
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Fax | 503-661-0677
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. MONICA E. COURTNEY
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Credential | OWNER
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Telephone | 503-544-5837
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 15-2170
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License Number State | OR
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