Waterfront Homecare LLC

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

Legal business name

WATERFRONT HOMECARE LLC

Practice address

730 SE Flint St
Roseburg, OR 97470-3428

Phone

(541) 375-0166

Fax

(541) 637-0211

NPI assigned

Sep 10, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Aaiza Dee

Title

Administrator

Phone

(541) 375-0166

Specialties & licenses 1

Addresses

Other names 1

• Waterfront Homecare Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1356177992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86895 N BANK LN",
            "city": "COQUILLE",
            "state": "OR",
            "postal_code": "974238613",
            "telephone_number": "541-375-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 SE FLINT ST",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974703428",
            "telephone_number": "541-375-0166",
            "fax_number": "541-637-0211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERFRONT HOMECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "DEE",
        "authorized_official_first_name": "AAIZA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "541-375-0166"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waterfront Homecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Diana Francesca Warren
• Jerry G Warren, MD
• Molly Anne Warren, PHARMACIST
• Warrior Service Company LLC
• David J Washburn, D.M.D.
• Grace Lynn Watkins
• Obadiah Watkins
• Abigail Watson
• Heidi Watson, LPC
• Julianne Watson, CNM

• Adult Care Home Facility in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Adult Care Home Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.