Provider Demographics
NPI:1508250762
Name:WEST LINN CARE CTR OPERATING CO, LLC
Entity Type:Organization
Organization Name:WEST LINN CARE CTR OPERATING CO, LLC
Other - Org Name:ROSE LINN CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-210-4749
Mailing Address - Street 1:2330 DEBOK RD
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-3902
Mailing Address - Country:US
Mailing Address - Phone:503-210-4749
Mailing Address - Fax:503-210-4051
Practice Address - Street 1:2330 DEOK RD.
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3902
Practice Address - Country:US
Practice Address - Phone:503-210-4749
Practice Address - Fax:503-210-4051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-26
Last Update Date:2015-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1687688171314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500646173Medicaid
OR500646173Medicaid