Provider Demographics
NPI:1770096810
Name:UNLAND LLC
Entity type:Organization
Organization Name:UNLAND LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:UNDERWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:417-280-6941
Mailing Address - Street 1:2401 LONGWOOD DR APT N
Mailing Address - Street 2:
Mailing Address - City:REEDSPORT
Mailing Address - State:OR
Mailing Address - Zip Code:97467-1162
Mailing Address - Country:US
Mailing Address - Phone:417-280-6941
Mailing Address - Fax:314-499-9047
Practice Address - Street 1:2401 LONGWOOD DR APT N
Practice Address - Street 2:
Practice Address - City:REEDSPORT
Practice Address - State:OR
Practice Address - Zip Code:97467-1162
Practice Address - Country:US
Practice Address - Phone:417-280-6941
Practice Address - Fax:314-499-9047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-12
Last Update Date:2017-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201502205251J00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care