Provider Demographics
NPI:1720604150
Name:WEST LINN CARE CENTER OPERATING COMPANY, LLC
Entity Type:Organization
Organization Name:WEST LINN CARE CENTER OPERATING COMPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALDROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-344-6065
Mailing Address - Street 1:1800 BLANKENSHIP RD STE 475
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-4248
Mailing Address - Country:US
Mailing Address - Phone:503-344-6065
Mailing Address - Fax:
Practice Address - Street 1:2330 DEBOK RD
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-3998
Practice Address - Country:US
Practice Address - Phone:503-655-0474
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-22
Last Update Date:2020-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)