Provider Demographics
NPI:1871212167
Name:INFINITE ADULT CARE LLC
Entity type:Organization
Organization Name:INFINITE ADULT CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:GEMECHIS
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDISSA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:971-401-0901
Mailing Address - Street 1:1321 SE 19TH CIR
Mailing Address - Street 2:
Mailing Address - City:TROUTDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97060-2380
Mailing Address - Country:US
Mailing Address - Phone:197-140-1090
Mailing Address - Fax:
Practice Address - Street 1:1321 SE 19TH CIR
Practice Address - Street 2:
Practice Address - City:TROUTDALE
Practice Address - State:OR
Practice Address - Zip Code:97060-2380
Practice Address - Country:US
Practice Address - Phone:197-140-1090
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty