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Organization
FOREST DRIVE OPERATIONS, LLC
Active
Organization
FOREST DRIVE OPERATIONS, LLC
Active
Other names
Suzanne Elise Assisted Living Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KARL RICKARD MILLER JR. (OWNER)
(503) 570-3405
Entity
Organization
Contact information
Practice address
101 FOREST DR, SEASIDE, OR 97138-7867
(503) 738-0307
(503) 717-8102
Mailing address
101 FOREST DR, SEASIDE, OR 97138-7867
(503) 738-0307
(503) 717-8102
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
1847571968
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
517786
—
OR
Enumeration date
07/28/2008
Last updated
07/28/2008
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