Provider Demographics
NPI:1841848538
Name:GENHIGHLINE LLC
Entity type:Organization
Organization Name:GENHIGHLINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:W
Authorized Official - Last Name:GABRIEL
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:503-594-2263
Mailing Address - Street 1:8440 SE SUNNYBROOK BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-5781
Mailing Address - Country:US
Mailing Address - Phone:035-652-0750
Mailing Address - Fax:
Practice Address - Street 1:1640 S QUEBEC WAY
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80231-8018
Practice Address - Country:US
Practice Address - Phone:303-732-6714
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility