Organization
ELDERLY AND DISABLED SERVICES
Active
Parent organization
ELDERLY AND DISABLED SERVICES
Other names
Restoration Home Stacey RTH
Organization subpart
Yes
Provider details
NPI number
Legal business name
ELDERLY AND DISABLED SERVICES
Authorized official
LARRY MICHAEL MCPHEE (OWNER)
(541) 261-1991
Entity
Organization
Contact information
Practice address
19536 SW STACEY ST, BEAVERTON, OR 97003-2521
(541) 261-1991
Mailing address
3126 STATE ST STE 100, MEDFORD, OR 97504-8665
(541) 261-1991
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/17/2023
Last updated
06/17/2025
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