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Organization

AT HOME SENIOR SOLUTIONS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RANDY BEAN (OWNER/DIRECTOR)
(541) 772-7070
Entity
Organization

Contact information

Practice address
700 E MAIN ST, SUITE 101, MEDFORD, OR 97504-7138
(541) 772-7070
(541) 779-0701
Mailing address
700 E MAIN ST, SUITE 101, MEDFORD, OR 97504-7138
(541) 772-7070
(541) 779-0701

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
15-2226
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500670432
OR
Enumeration date
04/23/2015
Last updated
04/23/2015
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