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General NPI Number Information
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NPI Number | 1871395491
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Entity Type | Organization
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Legal Business Name | ELITE CARE GRANT LLC
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Dates
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Enumeration Date | 03/25/2025
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Last Update Date | 03/25/2025
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Provider Practice Location Address
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Address Line | 12353 SW GRANT AVE
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City | TIGARD
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State | OR
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Zip | 97223
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Country | US
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Telephone | 503-583-7937
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Fax |
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Provider Business Mailing Address
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Address Line | 4444 SE OATFIELD HILL ROAD
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City | MILWAUKIE
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State | OR
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Zip | 97267
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Country | US
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Telephone | 503-653-5656
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RAEANN VOORHIES
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Credential | RN
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Telephone | 503-348-8587
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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 |
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License Number State |
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