RESCUE LIFE SENIOR CARE AGENCY (NPI# 1003307653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003307653 |
| Entity Type | Organization |
| Organization Name | RESCUE LIFE SENIOR CARE AGENCY |
| Practice Address |
12640 Se Stark St Portland OR 97233-1058 |
| Practice Telephone | 9713196171 |
| Mailing Telephone | 9713196171 |
| Mailing Fax Number | 9713526916 |
| Enumeration Date | 2018-05-18 |
| Last Update Date | 2018-05-18 |
| Authorized Official Name | ROSANNA S HUNNICUTT (PRESIDENT) |
| Authorized Official Telephone | 8182359253 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 253Z00000X | In Home Supportive Care | 15-2334 | OR | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 1104364900 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 12640 Se Stark St, Portland, OR 972331058 | 9713196171 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | RESCUE LIFE SENIOR CARE AGENCY INC. | 12640 Se Stark St, Portland, OR 97233 |
| Street Address |
12640 SE STARK ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97233-1058 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316019888 | Nena Valerie Johnstone | Psychologist | 12640 Se Stark St, Portland, OR 97233-1058 | 2006-11-13 |
| 1013048677 | Nena Johnstone Psy D PC | Psychologist | 12640 Se Stark St, Portland, OR 97233-1058 | 2007-03-08 |
| 1841338621 | Paula Bates Mike | Social Worker | 12640 Se Stark St, Portland, OR 97233-1058 | 2007-02-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205448164 | Moore Therapy Services, LLC | Behavioral Analyst | 2053 Se 181st Ave, Portland, OR 97233 | 2020-08-20 |
| 1427563733 | Central City Concern Inc | Clinic/Center | 1415 Se 122nd Ave, Portland, OR 97233 | 2017-12-08 |
| 1427573443 | Sunshine Ahc | In Home Supportive Care | 2217 Se 156th Ave, Portland, OR 97233 | 2017-08-10 |
| 1538609433 | Nathaniel Davis Jr. | Counselor | 8915 Se Center St, Tigard, OR 97233 | 2017-02-27 |
| 1154878627 | Oregon Outreach Inc | Case Management | 1740 South East 139th Avenue, Portland, OR 97233 | 2016-09-01 |
| 1023461019 | Julianne Baltzley | Counselor | 2409 Se 149th Avenue, Portland, OR 97233 | 2016-07-14 |
| 1710332143 | Emma Slater | Counselor | 12360 Se Burnside, Portland, OR 97233 | 2016-05-04 |
| 1245621952 | Gregory Brett Bledsoe | Counselor | 1427 Se 182nd Ave., Portland, OR 97233 | 2015-02-17 |
| 1396149852 | Jacqueline Bension | Counselor | 1705 Se 122nd Ave, Portland, OR 97233 | 2014-10-13 |
| 1700206950 | Olga I Zlatova I | Dental Hygienist | 325 Se 154th Ave, Portland, OR 97233 | 2014-04-25 |
| Find all providers in zip 97233 | ||||
| Taxonomy Code | 253Z00000X |
| Grouping | Agencies |
| Classification | In Home Supportive Care |
| An In Home Supportive Care Agency provides services in the patient’s home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790382638 | Compassionate Home Care of Maine LLC | In Home Supportive Care | 49 Ballpark Dr, Portland, ME 04103-1678 | 2020-10-05 |
| 1396352381 | Zara Homecare LLC | In Home Supportive Care | 19025 Se Yamhill St Apt 202, Portland, OR 97233-5578 | 2020-09-24 |
| 1750994984 | Mercy Home Care Agency LLC | In Home Supportive Care | 2057 Se 122nd Ave, Portland, OR 97233-1305 | 2020-08-27 |
| 1780201343 | Prestige Home Care, LLC | In Home Supportive Care | 75 Bishop St Ste 8, Portland, ME 04103-2614 | 2020-06-30 |
| 1356966063 | Tlc Angels, Inc | In Home Supportive Care | 1717 Congress St Ste 3, Portland, ME 04102-1983 | 2020-06-09 |
| 1619501954 | Sunshine Home Care LLC | In Home Supportive Care | 85 Grant St Apt A22, Portland, ME 04101-2285 | 2020-02-25 |
| 1528690021 | Veritas Care of Maine Inc | In Home Supportive Care | 570 Brighton Ave Ste B2, Portland, ME 04102-2357 | 2020-02-12 |
| 1255963559 | Portcity Home Healthcare LLC | In Home Supportive Care | 525 Forest Avenue, Suite 8, Portland, ME 04101 | 2020-02-05 |
| 1790322519 | Ismael A Ali | In Home Supportive Care | 246 Auburn St 112, Portland, ME 04103-0410 | 2019-12-01 |
| 1366096323 | Green Leaf Residential Care LLC | In Home Supportive Care | 24 Wellesley Ests, Portland, ME 04103-1170 | 2019-07-29 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.