Organization
DALLAS MENNONITE RETIREMENT COMMUNITY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GERALD J. MCMULLIN (BOARD CHAIR)
(503) 623-3843
Entity
Organization
Contact information
Practice address
377 NW JASPER ST, DALLAS, OR 97338-1279
(503) 623-5581
(503) 623-2901
Mailing address
377 NW JASPER ST, DALLAS, OR 97338-1279
(503) 623-5581
(503) 623-2901
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
800268
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
800268
—
OR
Enumeration date
11/29/2005
Last updated
12/28/2012
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