PREMIER LIVING CENTER INC. NPI 1669099768

NPI Information

NPI: 1669099768
Provider Name: PREMIER LIVING CENTER INC.

Doing Business As: PREMIER LIVING CENTER

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

Address:
5120 SE 118TH AVE
PORTLAND, OR
ZIP 97266
Phone: (503) 762-3413
Get Directions

PREMIER LIVING CENTER INC. is an assisted living facility in Portland, 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. PREMIER LIVING CENTER INC. NPI is 1669099768. The provider is registered as an organization entity type.
The provider Is Doing Business As Premier Living Center.

The provider's business location address is:

5120 SE 118TH AVE
PORTLAND, OR
ZIP 97266-250
Phone: (503) 762-3413
Fax: (503) 762-3428

The provider's authorized official is Jen Schnitzer .
The authorized official title is Director Of Operations and has the following contact phone number (541) 601-7228.

The CLIA number assigned to this NPI record is 38D2269265 - other - residential care facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/6/2020 and was last updated on 7/6/2020.

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
1	310400000X	Assisted Living Facility				Yes

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
1	503908	MEDICAID	OREGON

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: 4/28/2024

NPI Synchronization or Removal

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