Provider Demographics
NPI:1366068959
Name:TP HARVEST HOMES OPERATIONS LLC
Entity type:Organization
Organization Name:TP HARVEST HOMES OPERATIONS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAEANN
Authorized Official - Middle Name:
Authorized Official - Last Name:VOORHIES
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:503-348-8587
Mailing Address - Street 1:6921 N ROBERTS AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203
Mailing Address - Country:US
Mailing Address - Phone:503-286-2423
Mailing Address - Fax:
Practice Address - Street 1:6921 N ROBERTS AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203
Practice Address - Country:US
Practice Address - Phone:503-286-2423
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-19
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR503469Medicaid
OR529820OtherMEDICAID: SPECIAL NEEDS CONTRACT
OR502603Medicaid
OR521372Medicaid
OR529796Medicaid
OR529801Medicaid