Provider Demographics
NPI:1295553394
Name:THE COTTAGES OPCO LLC
Entity type:Organization
Organization Name:THE COTTAGES OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:WART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-706-6918
Mailing Address - Street 1:1808 SE 182ND AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-5120
Mailing Address - Country:US
Mailing Address - Phone:503-492-6942
Mailing Address - Fax:
Practice Address - Street 1:1808 SE 182ND AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97233-5120
Practice Address - Country:US
Practice Address - Phone:503-492-6942
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-28
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)