- Enrollment id
- O20070711000740
- Enrollment state
- OR
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1831306380
- Multiple npi flag
- N
- Ccn
- 385263
- Associate id
- 5294835872
- Organization name
- REGENCY HERMISTON NURSING & REHABILITATION CENTER, LLC
- Doing business as name
- HERMISTON NURSING & REHABILITATION CENTER
- Incorporation date
- 2007-05-15
- Incorporation state
- WA
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- REGENCY HERMISTON NURSING & REHAB CENTER
- Affiliation entity name
- REGENCY PACIFIC MANAGEMENT
- Affiliation entity id
- 442
- Address line 1
- 970 W JUNIPER AVE
- City
- HERMISTON
- State
- OR
- Zip code
- 978382118