Organization Name: | MIRABELLA AT SOUTH WATERFRONT |
NPI Number: | 1487975959 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHARON M MCCARTNEY (HEALTH SERVICES ADMINISTRATOR) |
Mailing Address: | 3550 Sw Bond Ave Portland |
State: | OR US |
Postal Code: | 972394506 |
Phone Number: | 5036886400 |
Fax Number: | |
NPI Enumeration Date: | 06/18/2010 |
NPI Last Update Date: | 04/18/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 1291022896 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OR |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |