Provider Demographics
NPI:1407833924
Name:TERRACE CORPORATION
Entity Type:Organization
Organization Name:TERRACE CORPORATION
Other - Org Name:TOWN CENTER VILLAGE REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:
Authorized Official - Last Name:KOBEL
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:503-654-4500
Mailing Address - Fax:503-786-1232
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:503-654-4500
Practice Address - Fax:503-786-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR385236314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR385236Medicare ID - Type Unspecified