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Organization
JEFFERSON MANOR RESIDENTIAL CARE, LLC
Active
Organization
JEFFERSON MANOR RESIDENTIAL CARE, LLC
Active
Other names
Jefferson Manor
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH MARIE MOSS (DIRECTOR OF RISK MANAGEMENT)
(503) 588-2725
Entity
Organization
Contact information
Practice address
664 SE JEFFERSON ST, DALLAS, OR 97338-2024
(503) 623-8104
(503) 623-0772
Mailing address
200 HAWTHORNE AVE SE STE A140, SALEM, OR 97301-5092
(503) 588-2725
(503) 588-8653
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
1087658107
OR
Other
Enumeration date
06/20/2008
Last updated
06/20/2008
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