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Contact Information

LAURELHURST VILLAGE LLC
3060 SE STARK ST
PORTLAND, OR97214-3053
 Phone: 503-535-4700
 Fax: 503-797-6702
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Assisted Living Facility

310400000X
 

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for LAURELHURST VILLAGE LLC

NPI Number 1346288362
LBN Legal business name LAURELHURST VILLAGE LLC
Authorized official TERESA WALOROFF - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 06/03/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
OR Medicaid 800093
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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