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General NPI Number Information
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NPI Number | 1952595340
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Entity Type | Organization
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Legal Business Name | INLAND POINT SENIOR ESTATES JV LLC
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 01/27/2009
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Provider Practice Location Address
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Address Line | 2265 INLAND DRIVE
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City | NORTH BEND
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State | OR
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Zip | 97459
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Country | US
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Telephone | 541-756-9740
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Fax | 541-756-9739
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Provider Business Mailing Address
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Address Line | 3696 BROADWAY ST PMB 132
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City | NORTH BEND
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State | OR
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Zip | 97459-2200
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Country | US
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Telephone | 541-756-9740
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Fax | 541-756-9739
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Authorized Official
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Title or Position | SENIOR EXECUTIVE DIRECTOR
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Name | ELIZABETH M MOSS
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Credential |
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Telephone | 541-756-0176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | APPLIED FOR
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License Number State | OR
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