Organization
PREFERRED COMMUNITY HOMES, LLC
Active
Other names
Preferred Community Homes - Mallard
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON MCARTHUR (CFO)
(503) 362-5235
Entity
Organization
Contact information
Practice address
699 S OTTER AVE, MERIDIAN, ID 83642-6144
(208) 288-2399
Mailing address
3155 RIVER RD S STE 100, SALEM, OR 97302-9819
(503) 362-5235
(503) 585-3267
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
LT032ID
—
AK
Enumeration date
02/16/2007
Last updated
08/22/2020
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