Organization
RESCUE LIFE SENIOR CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROSANNA S HUNNICUTT (PRESIDENT)
(818) 235-9253
Entity
Organization
Contact information
Practice address
12640 SE STARK ST, PORTLAND, OR 97233-1058
(971) 319-6171
Mailing address
12640 SE STARK ST, PORTLAND, OR 97233-1058
(971) 319-6171
(971) 352-6916
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
15-2334
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1104364900
—
OR
Enumeration date
05/18/2018
Last updated
05/18/2018
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