Provider Demographics
NPI:1629381454
Name:AIDAN SENIOR LIVING AT REEDWOOD, INC.
Entity Type:Organization
Organization Name:AIDAN SENIOR LIVING AT REEDWOOD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:N
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-588-4428
Mailing Address - Street 1:180 COMMERCIAL ST NE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-3487
Mailing Address - Country:US
Mailing Address - Phone:503-588-4428
Mailing Address - Fax:503-588-1087
Practice Address - Street 1:3540 SE FRANCIS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-3350
Practice Address - Country:US
Practice Address - Phone:503-232-5767
Practice Address - Fax:503-234-4162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility