Organization
PACIFIC LIVING CENTERS SOUTH, LLC
Active
Other names
Bartlett House of Medford, Applegate House of Grants Pass, Autumn House of Grants Pass, Arbor House of Grants Pass
Organization subpart
No
Provider details
NPI number
Authorized official
CARL MASON (COO)
(503) 826-5190
Entity
Organization
Contact information
Practice address
1635 KELLENBECK AVE, GRANTS PASS, OR 97527-4247
(541) 474-6493
Mailing address
25260 SW PARKWAY AVE STE B, WILSONVILLE, OR 97070-6627
(503) 826-5190
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3246694719
DHS APD
OR
01
—
5482307390
DHS APD
OR
01
—
7715251304
DHS APD
OR
01
—
8850499803
DHS APD
OR
Enumeration date
02/07/2022
Last updated
04/16/2025
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