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Organization

PRO-STEP REHAB

Active
Parent organization
EXTENDICARE
Other names
Care Center East
Organization subpart
Yes

Provider details

NPI number
Legal business name
EXTENDICARE
Authorized official
CHRISTINE M VAN OSDOL OT (FACILITY REHAB COORDINATOR)
(503) 253-1181
Entity
Organization

Contact information

Practice address
11325 NE WEIDLER ST, PORTLAND, OR 97220-1950
(503) 253-1181
(503) 253-1871
Mailing address
11325 NE WEIDLER ST, PORTLAND, OR 97220-1950
(503) 253-1181
(503) 253-1871

Taxonomy

Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
316072
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
316072
OCCUPATIONAL THERAPY LICENSE
OR
Enumeration date
10/29/2013
Last updated
10/29/2013
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