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Organization

FM CEDAR VILLAGE, LLC

Active
Other names
Cedar Village Assisted Living & Memory Care
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY A RODERICK (MEMBER)
(503) 443-1818
Entity
Organization

Contact information

Practice address
4452 LANCASTER DR NE, SALEM, OR 97305-1697
(503) 390-9600
(503) 390-9152
Mailing address
7420 SW BRIDGEPORT RD STE 105, PORTLAND, OR 97224-7790
(503) 597-4906
(503) 443-1919

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
526907
OR
05
526908
OR
Enumeration date
06/18/2020
Last updated
06/18/2020
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