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General NPI Number Information
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NPI Number | 1659723773
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Entity Type | Organization
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Legal Business Name | OROFINO RETIREMENT PROPERTIES INC
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 431 JOHNSON AVE
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City | OROFINO
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State | ID
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Zip | 83544-9516
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Country | US
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Telephone | 208-476-2000
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Fax | 208-476-7748
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Provider Business Mailing Address
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Address Line | 431 JOHNSON AVE
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City | OROFINO
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State | ID
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Zip | 83544-9516
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Country | US
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Telephone | 208-476-2000
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Fax | 208-476-7748
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. DANIEL L DUNHAM
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Credential | MHSM
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Telephone | 208-476-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | RC680
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License Number State | ID
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