Organization
NEW FRIENDS OF COOS BAY, LLC
Active
Organization
NEW FRIENDS OF COOS BAY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL MASON (DIRECTOR OF OPERATIONS)
(503) 826-5190
Entity
Organization
Contact information
Practice address
955 KENTUCKY AVE, COOS BAY, OR 97420-6807
(541) 808-9730
Mailing address
25260 SW PARKWAY AVE STE B, WILSONVILLE, OR 97070-6627
(503) 826-5190
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
528759
—
OR
Enumeration date
06/08/2021
Last updated
06/08/2021
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