Provider Demographics
NPI:1093107013
Name:TCV EMPLOYEES LLC
Entity Type:Organization
Organization Name:TCV EMPLOYEES LLC
Other - Org Name:THE FOUNTAINS AT TOWN CENTER VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SERVICE AND SYSTEMS
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:A
Authorized Official - Last Name:STAYNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-652-0750
Mailing Address - Street 1:8607 SE CAUSEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-7579
Mailing Address - Country:US
Mailing Address - Phone:503-653-1500
Mailing Address - Fax:
Practice Address - Street 1:8607 SE CAUSEY AVE
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-7579
Practice Address - Country:US
Practice Address - Phone:503-653-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-27
Last Update Date:2015-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility