Provider Demographics
NPI:1700554672
Name:DC WEST LINN OWNER, LLC
Entity Type:Organization
Organization Name:DC WEST LINN OWNER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SIGNATORY
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LEINBACH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-664-6500
Mailing Address - Street 1:23000 HORIZON DR
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-8247
Mailing Address - Country:US
Mailing Address - Phone:503-655-4373
Mailing Address - Fax:
Practice Address - Street 1:23000 HORIZON DR
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-8247
Practice Address - Country:US
Practice Address - Phone:503-655-4373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility