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General NPI Number Information
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NPI Number | 1871239384
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Entity Type | Organization
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Legal Business Name | ENGRACE HOSPICE LLC
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Dates
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Enumeration Date | 05/08/2022
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Last Update Date | 05/08/2022
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Provider Practice Location Address
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Address Line | 512 SW QUINNEY PL
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City | PENDLETON
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State | OR
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Zip | 97801-9461
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Country | US
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Telephone | 971-207-8402
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Fax |
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Provider Business Mailing Address
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Address Line | 9507 NE GERTZ CIR
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City | PORTLAND
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State | OR
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Zip | 97211-1269
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Country | US
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Telephone | 971-207-8402
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FABRICE ADJAM
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Credential |
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Telephone | 971-207-8402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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