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Organization
HISTORY MAKERS, INC.
Active
Organization
HISTORY MAKERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL FRANCES BROOKER-GARDNER RN (ADMINISTRATOR)
(541) 229-5263
Entity
Organization
Contact information
Practice address
220 CINBAR DR, ROSEBURG, OR 97471-9385
(541) 229-5263
(541) 229-5265
Mailing address
220 CINBAR DR, ROSEBURG, OR 97471-9385
(541) 229-5263
(541) 229-5265
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
15-2204
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
521319
—
OR
Enumeration date
09/10/2013
Last updated
09/10/2013
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