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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