Organization
MEADOWLAND ADULT FOSTER HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SUJAY KUMAR NAKKA (OWNER)
(503) 354-2523
Entity
Organization
Contact information
Practice address
706 MEADOW AVE, TILLAMOOK, OR 97141-2844
(503) 354-2523
(503) 354-5116
Mailing address
706 MEADOW AVE, TILLAMOOK, OR 97141-2844
(503) 354-2523
(503) 354-5116
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
500697789
OR
Other
Enumeration date
06/03/2016
Last updated
06/24/2016
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