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General NPI Number Information
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NPI Number | 1730815176
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Entity Type | Organization
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Legal Business Name | BIS CARE LLC
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 8642 SE JENNINGS AVE
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City | MILWAUKIE
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State | OR
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Zip | 97267-5457
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Country | US
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Telephone | 605-496-4836
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Fax | 503-344-6379
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Provider Business Mailing Address
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Address Line | 8642 SE JENNINGS AVE
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City | MILWAUKIE
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State | OR
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Zip | 97267-5457
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Country | US
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Telephone | 605-496-4836
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Fax | 503-344-6379
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Authorized Official
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Title or Position | OPERATOR/OWNER
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Name | BISRAT BERHE HABITE
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Credential | REGISTERED NURSE
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Telephone | 605-496-4836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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