Provider Demographics
NPI:1497294383
Name:CRH CHANDLER HOUSE LLC
Entity Type:Organization
Organization Name:CRH CHANDLER HOUSE LLC
Other - Org Name:CHANDLER HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-317-9188
Mailing Address - Street 1:PO BOX 1410
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97709-1410
Mailing Address - Country:US
Mailing Address - Phone:541-317-9188
Mailing Address - Fax:
Practice Address - Street 1:701 N 39TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-6343
Practice Address - Country:US
Practice Address - Phone:509-248-1007
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CRH NORTHWEST
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-02-13
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2156311500000X
WA2157311500000X
WA2158311500000X
WA2159311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)