Organization
AMAZING GRACE CARE HOMES, INCESIDENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRI M JEMISON (PRESIDENT)
(503) 999-8159
Entity
Organization
Contact information
Practice address
1205 BARNES AVE SE, SALEM, OR 97306-1539
(503) 999-8159
Mailing address
6995 SW NYBERG ST, SUITE X201, TUALATIN, OR 97062-7455
(503) 999-8159
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
511482
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500500049
MARION COUNTY MENTAL HEALTH AFC PROVIDER
OR
Enumeration date
02/04/2017
Last updated
02/04/2017
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