Organization
PROFESSIONAL HOME CARE
Active
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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