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GENESIS NEWBERG OPERATION CO. LLC NPI 1659398469


NPI Information

NPI: 1659398469
Provider Name: GENESIS NEWBERG OPERATION CO., LLC

Doing Business As: AVAMERE AT NEWBERG

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization

CLIA Number: 38D2197359

Address:
730 FOOTHILLS DR
NEWBERG, OR
ZIP 97132
Phone: (503) 554-0767
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GENESIS NEWBERG OPERATION CO., LLC is an assisted living facility in Newberg, OR. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. GENESIS NEWBERG OPERATION CO., LLC NPI is 1659398469. The provider is registered as an organization entity type.
The provider Is Doing Business As Avamere At Newberg.

The provider's business location address is:

730 FOOTHILLS DR
NEWBERG, OR
ZIP 97132-004
Phone: (503) 554-0767

The provider's authorized official is K. Rickard Miller .
The authorized official title is Manager and has the following contact phone number (503) 570-3405.

The CLIA number assigned to this NPI record is 38D2197359 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/16/2006 and was last updated on 7/30/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1505092MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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