Organization · Type 2 NPI

Avalon Care Center - Portland LLC

Nursing Facility/Intermediate Care Facility · Portland, OR

NPI number 1538813670 Active

Practice location

12640 SE Bush St
Portland, OR 97236-3423

Call (503) 761-6621 Map

Mailing address

206 N 2100 W
Salt Lake City, UT 84116-4740

Specialties and licenses

Taxonomy	Code	License
Nursing Facility/Intermediate Care Facility Primary	313M00000X	None listed

Nursing Facility/Intermediate Care Facility: An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical conditi…

2 other providers at this address

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NPI record

NPI: 1538813670
Entity type: Organization (Type 2)
Issued: Feb 8, 2022
Last updated: Aug 17, 2022
Status: Active

Other names

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Avalon Care Center - Portland · doing business as
Avalon Care Center - Portland · doing business as
Avalon Residential Care Center Portland · doing business as

Authorized official

Charles Kirton
CEO/chairman
(801) 596-8844

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1538813670

Avalon Care Center - Portland LLC's National Provider Identifier is 1538813670, issued on Feb 8, 2022. The primary taxonomy on file is Nursing Facility/Intermediate Care Facility (313M00000X), and the practice location is in Portland, OR. The record was last updated on Aug 17, 2022.