Organization
PREFERRED COMMUNITY HOMES, LLC
Active
Other names
Preferred Community Homes - Cougar
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON MCARTHUR (CFO)
(503) 362-5235
Entity
Organization
Contact information
Practice address
1230 E COUGAR CREEK DR, MERIDIAN, ID 83642-7807
(208) 888-4417
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
—
LT035ID
—
AK
Enumeration date
02/20/2007
Last updated
08/22/2020
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