National Provider Identifier Database

PROVIDENCE HEALTH SERVICES OREGON
Skilled Nursing Facility

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.


Contact Information

PROVIDENCE HEALTH & SERVICES OREGON
540 S MAIN ST
MOUNT ANGEL, OR97362-9540
Phone: 503-845-6841
Fax: 503-845-9229
Website:
Specialty Taxonomy Code
* Skilled Nursing Facility 314000000X
Nursing Facility/Intermediate Care Facility 313M00000X

* Indicates primary specialty

NPI Profile & details for PROVIDENCE HEALTH & SERVICES OREGON

NPI Number 1417978164
Legal business name
LBN
PROVIDENCE HEALTH & SERVICES OREGON
Authorized official DONALD ANDERSON - (ASSISTANT SECRETARY OF ENROLLMENTS)
Entity Organization
Organization subpart No
Enumeration date 07/21/2006
Last updated 05/15/2025 - More than a year ago
Sole proprietor1 Not specified
Identifiers
  • OR License #: 385018
  • OR Medicaid: 800006

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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