Organization
CHESTNUT LANE OPERATIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARL MILLER JR. (CEO)
(503) 570-3405
Entity
Organization
Contact information
Practice address
1219 NE 6TH ST, GRESHAM, OR 97030-7348
(503) 674-0364
Mailing address
1219 NE 6TH ST, GRESHAM, OR 97030-7348
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
07/29/2019
Last updated
07/29/2019
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