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Organization

PERSONAL HOME CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. LISA DESIREE FOLLIS (OFFICE MANAGER)
(503) 371-1495
Entity
Organization

Contact information

Practice address
2659 COMMERCIAL ST SE, SUITE 290, SALEM, OR 97302-4445
(503) 371-1495
(503) 371-1612
Mailing address
PO BOX 4246, SALEM, OR 97302-8246
(503) 371-1495
(503) 371-1612

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
15-2020
OR

Other

Enumeration date
11/03/2008
Last updated
11/03/2008
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