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Organization
FM OCEAN CREST, LLC
Active
Organization
FM OCEAN CREST, LLC
Active
Other names
Bayside Terrace Assisted Living and Memory Care
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY A RODERICK (MEMBER)
(503) 443-1818
Entity
Organization
Contact information
Practice address
192 NORMAN AVE, COOS BAY, OR 97420-4741
(541) 888-2255
(541) 888-5908
Mailing address
7420 SW BRIDGEPORT RD STE 105, PORTLAND, OR 97224-7790
(503) 597-4906
(503) 443-1818
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
526904
—
OR
05
—
526920
—
OR
Enumeration date
06/18/2020
Last updated
06/18/2020
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