Pci Care Venture I Inc.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

PCI CARE VENTURE I INC.

Doing business as

Forest Grove Rehabilitation and Care Center

Practice address

3900 Pacific Ave
Forest Grove, OR 97116-2226

Phone

(503) 359-0449

Fax

(503) 357-8086

NPI assigned

Sep 21, 2005

Organization subpart

No

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

Authorized official

Name

Gregory J Vislocky

Title

Exec. VP of Finance

Phone

(360) 735-7155

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Forest Grove Rehabilitation and Care Center Doing business as

Locations

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

{
    "created_epoch": "1127260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255996800000",
    "number": "1780670182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7700 NE PARKWAY DR",
            "address_2": "SUITE 300",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986626648",
            "telephone_number": "360-735-7155",
            "fax_number": "360-735-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 PACIFIC AVE",
            "city": "FOREST GROVE",
            "state": "OR",
            "postal_code": "971162226",
            "telephone_number": "503-359-0449",
            "fax_number": "503-357-8086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PCI CARE VENTURE I INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-21",
        "last_updated": "2009-10-20",
        "status": "A",
        "authorized_official_last_name": "VISLOCKY",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EXEC. VP OF FINANCE",
        "authorized_official_telephone_number": "360-735-7155"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "800115",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Forest Grove Rehabilitation and Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Linda Marie Paoluccio, LPC, QMHP
• Susie Dos Santos Papel
• Eileen H Park
• Nathan Alan Patterson, O.D.
• Shagun Pawar, PSYD
• Alejandra Gabriela Penaloza Ramirez
• Rebecca Lynn Pence, OTR/L
• Paola Pereira, MSW
• Celeste Perez
• Lisa S Peterson, MT-BC

• Skilled Nursing Facility in Forest Grove, OR
• Providers in Forest Grove, OR by specialty
• Skilled Nursing Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2009; 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.