Provider Demographics
NPI:1124276118
Name:ALECA HOME HEALTH OREGON LLC
Entity type:Organization
Organization Name:ALECA HOME HEALTH OREGON LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHAEFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:503-201-8356
Mailing Address - Street 1:1220 20TH ST SE STE 310
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-1205
Mailing Address - Country:US
Mailing Address - Phone:503-954-2197
Mailing Address - Fax:503-954-2198
Practice Address - Street 1:1220 20TH ST SE STE 310
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-1205
Practice Address - Country:US
Practice Address - Phone:503-954-2197
Practice Address - Fax:503-954-2198
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-03
Last Update Date:2024-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
OR251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500653374Medicaid
OR500653374Medicaid