Provider Demographics
NPI:1235543000
Name:ABLE PALMS HOME HEALTH OF OREGON, LLC
Entity Type:Organization
Organization Name:ABLE PALMS HOME HEALTH OF OREGON, LLC
Other - Org Name:ABLE PALMS HOME HEALTH OF OREGON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENET
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:B
Authorized Official - Last Name:GOODMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-361-8000
Mailing Address - Street 1:1107 HAZELTINE BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1009
Mailing Address - Country:US
Mailing Address - Phone:952-361-8000
Mailing Address - Fax:952-361-8060
Practice Address - Street 1:11520 SE SUNNYSIDE RD
Practice Address - Street 2:STE 308
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-4306
Practice Address - Country:US
Practice Address - Phone:503-698-1615
Practice Address - Fax:503-698-1626
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-19
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health