- Enrollment id
- O20231026002492
- Enrollment state
- OR
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1861106155
- Multiple npi flag
- N
- Ccn
- 385161
- Associate id
- 7517313562
- Organization name
- MILTON FREEWATER SNF OPERATIONS, LLC
- Doing business as name
- MILTON FREEWATER HEALTH & REHABILITATION CENTER
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- MILTON FREEWATER HEALTH AND REHABILITATION
- Affiliation entity name
- EVERGREEN HEALTHCARE GROUP
- Affiliation entity id
- 846
- Address line 1
- 120 ELZORA ST
- City
- MILTON FREEWATER
- State
- OR
- Zip code
- 978629454