Provider Demographics
NPI:1144773839
Name:SIRV INC
Entity Type:Organization
Organization Name:SIRV INC
Other - Org Name:HOMEWELL CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:SPAULDING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-344-6044
Mailing Address - Street 1:12901 SE 97TH AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-7907
Mailing Address - Country:US
Mailing Address - Phone:503-344-6044
Mailing Address - Fax:503-344-6175
Practice Address - Street 1:12901 SE 97TH AVE STE 408
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-7907
Practice Address - Country:US
Practice Address - Phone:503-344-6044
Practice Address - Fax:503-344-6175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-28
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15-2263253Z00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care