Organization
PROVIDENCE HEALTH & SERVICES OREGON
Active
Other names
Providence Benedictine Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD W ANDERSON JR. (ASSISTANT SECRETARY OF ENROLLMENTS)
(425) 358-9786
Entity
Organization
Contact information
Practice address
540 S MAIN ST, MOUNT ANGEL, OR 97362-9540
(503) 845-6841
(503) 845-9229
Mailing address
540 S MAIN ST, MOUNT ANGEL, OR 97362-9540
(503) 845-6841
(503) 845-9229
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
385018
OR
314000000X
Skilled Nursing Facility
Primary
385018
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800006
—
OR
Enumeration date
07/21/2006
Last updated
05/15/2025
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