Provider Demographics
NPI:1316402589
Name:PIONEER RELIEF NURSERY INC
Entity type:Organization
Organization Name:PIONEER RELIEF NURSERY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KATE
Authorized Official - Middle Name:
Authorized Official - Last Name:LACEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-215-1017
Mailing Address - Street 1:PO BOX 584
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:OR
Mailing Address - Zip Code:97801-0584
Mailing Address - Country:US
Mailing Address - Phone:541-215-1017
Mailing Address - Fax:541-215-1018
Practice Address - Street 1:1312 SW 2ND ST
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:OR
Practice Address - Zip Code:97801-4160
Practice Address - Country:US
Practice Address - Phone:541-215-1017
Practice Address - Fax:541-215-1018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care