Forest Glen

NPI 1871611350 - Assisted Living Facility - 310400000X

NPI Details
NPI 1871611350
Enumeration Date 03/26/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JON JON
Position MANAGER
Phone (541) 839-4266
Fax
Practice Location
200 SW FRONTAGE
CANYONVILLE OR, 97417, US
Phone (541) 839-4266
Fax
Business Location
3723 FAIRVIEW INDUSTRIAL DR SE STE 270
SALEM OR, 97302-4975, US
Phone (503) 485-4600
Fax
Toxanomy
Taxonomy Code 310400000X
License State
License Number
Remove 1871611350 NPI Number
 

According to our database, Forest Glen NPI is 1871611350, taxonomy code is 310400000X Forest Glen physically located at 200 Sw Frontage, Canyonville OR, 97417. NPI Number 1033115704 has the healthcare provider type.

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1871611350 NPI number is provided on an as is basis without warranty of any kind. 1871611350 is maintained by the National Plan & Provider Enumeration System. The contents of Forest Glen are for informational purposes only.