Provider Demographics
NPI:1033679618
Name:FVE MANAGERS, INC.
Entity type:Organization
Organization Name:FVE MANAGERS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:F
Authorized Official - Last Name:MINTZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-796-8104
Mailing Address - Street 1:8607 SE CAUSEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086-7579
Mailing Address - Country:US
Mailing Address - Phone:503-654-4500
Mailing Address - Fax:
Practice Address - Street 1:8607 SE CAUSEY AVE
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-7579
Practice Address - Country:US
Practice Address - Phone:503-654-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FVE MANAGERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-03-21
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR527954Medicaid