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NPI Code Detail

MEDICARE: ZENBRIO HOUSE, LLC

MEDICARE: ZENBRIO HOUSE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261Q00000XClinic/Center

General Provider Information

NPI Number : 1841761442
Entity Type Code : Organization
Provider Name (Legal Business Name) : ZENBRIO HOUSE, LLC
Provider Business Mailing Address
First Line : 1260 PRESIDENT ST
Second Line :
City : EUGENE
State : OR
Zip : 97401-5351
Country : US
Telephone Number : 541-953-4537
Fax Number :
Provider Business Practice Location Address
First Line : 1725 PEARL ST
Second Line :
City : EUGENE
State : OR
Zip : 97401-4118
Country : US
Telephone Number : 541-953-4537
Fax Number :
Authorized Official
Title or Position : OWNER
Name : SARA MCRAE
Credential :
Telephone Number : 541-953-4537
Provider Enumeration Date : 12/09/2018
Last Update Date : 12/09/2018

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Directions to “ZENBRIO HOUSE, LLC ” Practice Location

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