OrganizationActive
Jefferson Manor Residential Care, LLC
NPI 1669633707 · Alzheimer Center (Dementia Center) · Dallas, OR
Provider details
- NPI number
- 1669633707
- Entity type
- Organization
- Primary specialty
- Alzheimer Center (Dementia Center)Nursing & Custodial Care Facilities
- Authorized official
- Elizabeth Moss, Director of Risk Management
- License
- 1087658107 (OR)
Practice location
664 Se Jefferson St
Dallas, OR 97338-2024
Phone: (503) 623-8104
Fax: (503) 623-0772
Mailing address
200 Hawthorne Ave Se Ste A140
Salem, OR 97301-5092
Registry dates
- Enumerated
- 2008-06-20
- Last updated
- 2008-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.