Provider Demographics
NPI:1790170942
Name:APS HEALTHCARE
Entity Type:Organization
Organization Name:APS HEALTHCARE
Other - Org Name:UNIVERSAL AMERICA
Other - Org Type:Other Name
Authorized Official - Title/Position:SUPERVISOR
Authorized Official - Prefix:MS
Authorized Official - First Name:TERI
Authorized Official - Middle Name:
Authorized Official - Last Name:OLEARY
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:503-885-5121
Mailing Address - Street 1:7668 SW MOHAWK ST
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8119
Mailing Address - Country:US
Mailing Address - Phone:541-690-6643
Mailing Address - Fax:186-635-0131
Practice Address - Street 1:7668 SW MOHAWK ST
Practice Address - Street 2:
Practice Address - City:TUALATIN
Practice Address - State:OR
Practice Address - Zip Code:97062-8119
Practice Address - Country:US
Practice Address - Phone:541-690-6643
Practice Address - Fax:186-635-0131
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-04
Last Update Date:2015-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR082010607RN251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management