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Organization
WAVERLY ASSISTED LIVING, LLC
Active
Organization
WAVERLY ASSISTED LIVING, LLC
Active
Other names
Wellness at Home in Albany
Organization subpart
No
Provider details
NPI number
Authorized official
KIM BISTRONG PT (ADMINISTRATOR)
(971) 280-0677
Entity
Organization
Contact information
Practice address
2853 SALEM AVE SE STE A, ALBANY, OR 97321
(541) 650-6200
(541) 981-2211
Mailing address
2853 SALEM AVE SE STE A, ALBANY, OR 97321
(541) 650-6200
(541) 981-2211
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
38-7165
AGENCY LICENSE
OR
05
—
500757550
—
OR
Enumeration date
11/28/2018
Last updated
08/09/2021
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