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Organization

PROFESSIONAL HOME CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALOLA CAMPBELL (OWNER)
(541) 342-8302
Entity
Organization

Contact information

Practice address
3318 LAKESIDE DR, EUGENE, OR 97401-1592
(541) 342-8302
(541) 342-3876
Mailing address
3318 LAKESIDE DR, EUGENE, OR 97401-1592
(541) 342-8302
(541) 342-3876

Taxonomy

Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
15-2069
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
702946
OR
Enumeration date
03/09/2007
Last updated
08/22/2020
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