6/4/2018 adult foster homes: clatsop, marion,...

6/4/2018 ADULT FOSTER HOMES: CLATSOP, MARION, POLK, TILLAMOOK and YAMHILL

146

PROVIDER NAME

ADDRESS

NAME OF HOMERESIDENT MANAGERTELEPHONE

WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:No

Prov Number:514995

CLASS 2Address:560 Mill Stream Woods

Telephone:(503) 767-6200

Yes

MEDICAID Yes

Aburto, Guadalupe

Text77:Stayton OR 97383

Ca5

1

Smoking:No

Prov Number:512711

CLASS 2Address:5040 Barnes Ct. SE

Telephone:(503) 371-1626

Yes

MEDICAID Yes

Aburto, Roger

Text77:Salem OR 97306 2

Ca5 Smoking:Outside

Prov Number:507292

CLASS 3Address:1101 NE Chehalem Dr

Telephone:(503) 538-9746

Yes

MEDICAID Yes

DJ Adult Care Home, Inc.Aebischer, Joann

Text77:Newberg OR 97132

Ca5 Smoking:Yes

Prov Number:526463

CLASS 2Address:1380 Clay St NE Susan Cook/Tammy Yo

Telephone:(503) 551-4622

Yes

MEDICAID Yes

Alagoz, Fitina "Tina"

Text77:Salem OR 97301

Ca5 Smoking:Outside

Prov Number:523053

CLASS 2Address:4618 Indiana Ave NE Tammy Younce-float

Telephone:(503) 551-4622

Yes

MEDICAID Yes

Country Meadow Care AFHAlagoz, Tina


Ca5 Smoking:Outside

Prov Number:517665

CLASS 2Address:863 Meadowvale Lane Christina Schiedler

Telephone:(503) 551-4622

Yes

MEDICAID Yes

Country Meadow Care AFHAlagoz, Tina

Text77:Woodburn OR 97071 1

Ca5 Smoking:No

Prov Number:523452

CLASS 2Address:1244 SE Godsey Rd

Telephone:(503) 751-1394

Yes

MEDICAID Yes

Zoe Adult Foster CareAlleman, Merlita

Text77:Dallas OR 97338

Ca5 Smoking:No

Prov Number:525718

CLASS 2Address:315 SE Ironwood Ave

Telephone:(503) 420-4192

Yes

MEDICAID Yes

Zoe Adult Foster CareAlleman, Merlita & Eddis


Ca5 Smoking:Y

Prov Number:525955

CLASS 2Address:4985 Fontana St SE

Telephone:(503) 391-8157

Y

MEDICAID Y

United CareAngulo, Michelle


Ca5 Smoking:Outside

Prov Number:518286

CLASS 2Address:4514 47th Ave NE Laura Flores

Telephone:(503) 990-8947

Yes

MEDICAID Yes

Blue Moon Home LLCAngulo, Nathalie


Ca5 Smoking:Outside

Prov Number:500473

CLASS 2Address:6581 Peter Rd SE

Telephone:(503) 749-4087

Yes

MEDICAID Yes

Appleton, Wanda

Text77:Aumsville OR 97325

6/4/2018 (P) = Pending; DC = DayCare; RB = Room and Board Clatsop, Marion, Polk, Tillamook, Yamhill

of 13

Public disclosure files on Adult Foster Homes are available for review. Contact the foster home licensing staff (503-304-3400) for an appointment. Master Lists are available in alternate format.

PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:No

Prov Number:506349

CLASS 2Address:389 Ben Brown Lane

Telephone:(503) 982-0381

Yes

MEDICAID Yes

Helping Hands FHArceo, Enriqueta

Text77:Woodburn OR 97071

Ca5 Smoking:No

Prov Number:582200

CLASS 2Address:4330 Monroe Ave NE

Telephone:(503) 391-4706

Yes

MEDICAID Yes

Arnautov, Michael & Tanya


Ca5 Smoking:Outside

Prov Number:524096

CLASS 3Address:1870 Walker Rd NE

Telephone:(503) 689-4964

Yes

MEDICAID Yes

Young at Heart Adult Foster CareAult, Alesha & Eric


Ca5 Smoking:Outside

Prov Number:524386

CLASS 2Address:1909 Wareham Lane Dexter Alfonzo

Telephone:(503) 487-6366

Yes

MEDICAID Yes

Angel's Place Adult Care Home LLCBailey, Beulanbeth


Ca5 Smoking:Outside

Prov Number:518959

CLASS 2Address:1919 Wareham Lane Lydia Muna

Telephone:(503) 487-6343

Yes

MEDICAID Yes

Angel's Place Adult Care Home LLCBailey, Beulanbeth


Ca5 Smoking:No

Prov Number:525678

CLASS 2Address:130 NW Reed Lane

Telephone:(503) 623-2538

Yes

MEDICAID Yes

AAA Shepherd's Care HomeBarajas, Patricia, Bushaw, Nic


Ca5 Smoking:Outside

Prov Number:523628

CLASS 2Address:276 44th Ave SE Michael Smith

Telephone:(503) 409-8030

Yes

MEDICAID Yes

Kindred Hearts Care HomeBartlett, David & Lynn


Ca5 Smoking:No

Prov Number:525432

CLASS 2Address:635 Foxglove St SE Mary Cotter

Telephone:(503) 409-8030

Yes

MEDICAID Yes

Kindred Hearts Care Home LLCBartlett, David & Lynn


Ca5 Smoking:Outside

Prov Number:524663

CLASS 2Address:4114 Barrett St SE Raeven Earhart

Telephone:(503) 409-8030

Yes

MEDICAID Yes

Kindred Hearts Care Home LLCBartlett, Lynn & David


Ca5 Smoking:Outside

Prov Number:521337

CLASS 2Address:4286 Camellia Dr S Christy Regian

Telephone:(503) 409-8030

Yes

MEDICAID Yes



Ca5 Smoking:Outside

Prov Number:527179

CLASS 2Address:5668 Moonstone Loop SE Michiyo McEwen

Telephone:(503) 409-8030

Yes

MEDICAID Yes



Ca5 Smoking:No

Prov Number:526021

CLASS 2Address:3405 13th Pl SE

Telephone:(971) 701-6979

Yes

MEDICAID Yes

Heart of Living Home Care LLCBlakely, Fatoumata



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:Outside

Prov Number:522046

CLASS 2Address:2567 Fisher Rd NE Amy Skurlock

Telephone:(971) 338-8501

Yes

MEDICAID Yes

Valley Care AFHBodunov, Marimea


Ca4 Smoking:No

Prov Number:526359

CLASS 3Address:552 Idylwood Dr SE

Telephone:(503) 364-3359

Yes

MEDICAID Yes

Seniors Care Sweet HomeBordea, Oana


Ca4 Smoking:Outside

Prov Number:525651

CLASS 2Address:1125 S 4th St. Gina Anderson

Telephone:(503) 838-0173

Yes

MEDICAID Yes

Independence Specialized Care, LLCBorzy, Jason

Text77:Independence OR 97351

Ca5

1

Smoking:Outside

Prov Number:504048

CLASS 2Address:7290 O'Neil Road

Telephone:(503) 390-8056

No

MEDICAID Yes

Rosewood House Adult Foster CareBradshaw, Patricia

Text77:Keizer OR 97303

Ca5

1

Smoking:Outside

Prov Number:515939

CLASS 2Address:2853 Rocky Ridge Ave SE

Telephone:(503) 588-5579

Yes

MEDICAID Yes

Breyer, Alice


Ca5 Smoking:Outside

Prov Number:527178

CLASS 2Address:1814 Allendale Way NE

Telephone:(503) 400-8145

No

MEDICAID Yes

Hope Ranch AFH Inc.Brichuk, Alex


Ca5 Smoking:No

Prov Number:525785

CLASS 2Address:1098 Clearview Ave NE

Telephone:(503) 581-7723

Yes

MEDICAID Yes

Hope Ranch AFH, IncBrichuk, Valentina


Ca5 Smoking:No

Prov Number:527470

CLASS 2Address:2040 Paragon Ct NW Neisapeong Rosokow

Telephone:(971) 304-7092

Yes

MEDICAID No

Intuitive Care LLCBustamante, Jennifer


Ca5 Smoking:Outside

Prov Number:521163

CLASS 2Address:588 SE Walnut Ave Amber Williams

Telephone:(503) 623-4442

Yes

MEDICAID No

Pacific Northwest Care Corp.Clubb, Lisa


Ca5 Smoking:Outside

Prov Number:503022

CLASS 2Address:8520 Aumsville Hwy SE

Telephone:(503) 749-1357

Yes

MEDICAID Yes

Coleman, Vernon (Mike)


Ca3 Smoking:No

Prov Number:519062

CLASS 2Address:3331 Tierra Dr. NE

Telephone:(503) 588-8170

Yes

MEDICAID Yes

Conley, Lucy "Vi"


Ca5 Smoking:

Prov Number:525585

CLASS 2Address:289 Apple Blossom Ave N

Telephone:(971) 273-7188

Yes

MEDICAID No

Cook, Sharon



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:No

Prov Number:524044

CLASS 2Address:935 NW 20th Street

Telephone:(503) 857-0249

Yes

MEDICAID Yes

Rosalie's Adult Foster Care Home LLCCordero, Rosalie

Text77:McMinnville OR 97128

Ca5 Smoking:Outside

Prov Number:519050

CLASS 2Address:13555 Ekroth Rd

Telephone:(503) 322-0291

Yes

MEDICAID Yes

Miami River Inn Elder CareCrabb, Janna

Text77:Bay City OR 97107

Ca5 Smoking:No

Prov Number:505682

CLASS 3Address:1164 Irving Ave

Telephone:(503) 338-6922

Yes

MEDICAID Yes

St. Anne's Adult Foster HomeCroos, Soosaiappu

Text77:Astoria OR 97103

Ca3 Smoking:No

Prov Number:526457

CLASS 3Address:4704 Chatham St SE Kaitlin Cruse

Telephone:(503) 364-3009

Yes

MEDICAID Yes

Honored Living LLCCruse, Maria


Ca5

1

Smoking:No

Prov Number:526523

CLASS 2Address:2404 Rogers Lane NW James Ramos

Telephone:(503) 930-2656

Yes

MEDICAID Yes

Paramount Memory Care LLCCuanas & Odighizuwa, Meliss


Ca5 Smoking:No

Prov Number:521367

CLASS 2Address:2414 Rogers Ln NW Karina Barquinero

Telephone:(503) 990-8315

Yes

MEDICAID Yes

Prestige Memory Care Home IncCuanas & Odighizuwa, Meliss


Ca5 Smoking:Outside

Prov Number:524019

CLASS 3Address:510 Brandon Drive

Telephone:(503) 621-8189

Yes

MEDICAID Yes

Gentle Care Senior HomeDan, Simona


Ca4 Smoking:No

Prov Number:587290

CLASS 3Address:197 Heritage Ct

Telephone:(503) 982-8771

Yes

MEDICAID Yes

Beverly Rose Davis AFHDavis & Pureco, Beverly & Ma


Ca5 Smoking:Outside

Prov Number:508850

CLASS 2Address:5491 Beechwood St S Victoria Ditkovsky

Telephone:(971) 678-3827

Yes

MEDICAID Yes

Derli, Dina


Ca4 Smoking:Outside

Prov Number:525297

CLASS 2Address:5568 Murray St SE Dimitriy Derli

Telephone:(971) 678-3827

No

MEDICAID Yes

Derli, Dina


Ca5 Smoking:No

Prov Number:526063

CLASS 2Address:1475 Sandstone Ct. S Leila Narvarte

Telephone:(503) 931-1886

Yes

MEDICAID Yes

Caring Homes Plus LLCDeWilde, Arie


Ca5 Smoking:No

Prov Number:501532

CLASS 2Address:451 Eagle Feather St. NW

Telephone:(503) 931-1886

Yes

MEDICAID No

Caring Homes Plus LLCDeWilde, Arie, Delgado, Delia



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:Outside

Prov Number:508371

CLASS 2Address:21690 Hwy 47

Telephone:(503) 662-3843

Yes

MEDICAID Yes

Elva Dietzel AFHDietzel, Elva & PJ

Text77:Yamhill OR 97148

Ca5 Smoking:Outside

Prov Number:526755

CLASS 2Address:2345 Myrtle Ave NE

Telephone:(503) 585-1460

No

MEDICAID Yes

Elliott Care HomeElliott, Ezmeralda


Ca5 Smoking:Outside

Prov Number:515207

CLASS 2Address:2207 Juliet Ct SE

Telephone:(503) 871-8629

Yes

MEDICAID No

Sweet Bye N ByeEstrada, Angela


Ca5 Smoking:Outside

Prov Number:513722

CLASS 2Address:4072 Brooks Ave NE Dickerson / McEwen

Telephone:(503) 871-8629

Yes

MEDICAID No



Ca5

1

Smoking:Outside

Prov Number:516811

CLASS 2Address:715 Wildflower St NE Sheila Hunt

Telephone:(503) 871-8629

Yes

MEDICAID No



Ca5 Smoking:Outside

Prov Number:516189

CLASS 3Address:890 Mule Deer Place NW

Telephone:(503) 871-8629

Yes

MEDICAID no



Ca5 Smoking:Outside

Prov Number:523271

CLASS 2Address:1360 Clay St. NE

Telephone:(503) 409-0192

Yes

MEDICAID Yes

Hazelgreen Senior Living, LLCFrancke, Kevin


Ca5 Smoking:Outside

Prov Number:520966

CLASS 2Address:5664 Moonstone Loop SE Iris Ayala

Telephone:(503) 585-3363

Yes

MEDICAID Yes

Celebrate TodayGarcia, Veronica


Ca5 Smoking:No

Prov Number:525959

CLASS 2Address:2676 Tahoe Ave SE

Telephone:(503) 581-8385

Yes

MEDICAID Yes

Felicity Haven Adult Foster HomeGlenn, Evelyn


Ca4 Smoking:Outside

Prov Number:517784

CLASS 3Address:501 Railroad Ave

Telephone:(503) 738-6714

Yes

MEDICAID Yes

Graber, Joyce, Hanson, Robin

Text77:Gearhart OR 97138

Ca5

1

Smoking:No

Prov Number:525366

CLASS 2Address:248 Elma Ave SE

Telephone:(503) 602-5015 MEDICAID Yes

A Place Like Home LLCGreer, Helen & James


Ca5 Smoking:Outside

Prov Number:523540

CLASS 2Address:3950 Lone Oak Rd SE

Telephone:(503) 385-8126

Yes

MEDICAID Yes

A Place Like Home, LLCGreer, Helen & James



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:Outside

Prov Number:515406

CLASS 2Address:4322 Oregon Trail Ct. NE Major Harris

Telephone:(503) 856-9186

Yes

MEDICAID Yes

Living Word Estates, LLCHarris, Clara


Ca5 Smoking:Outside

Prov Number:524387

CLASS 2Address:4773 Whitman Cir NE

Telephone:(503) 304-2273

Yes

MEDICAID Yes

Perfect Love and CareHarris, Monique


Ca4 Smoking:Outside

Prov Number:520016

CLASS 2Address:664 Orchard Drive

Telephone:(503) 623-8407

Yes

MEDICAID Yes

Dorothy Hartley's AFHHartley, Dorothy


Ca5 Smoking:Outside

Prov Number:514816

CLASS 2Address:3565 Belle Vista Ct S

Telephone:(503) 362-2905

Yes

MEDICAID Yes

Herne, Andreea


Ca5 Smoking:No

Prov Number:518911

CLASS 2Address:1270 Madrona Ave S Leah Lekka/Angela Fug

Telephone:(503) 798-5610

Yes

MEDICAID No

Premier Care HomesHibner, Margie, LeFore, Janell


Ca5 Smoking:No

Prov Number:520157

CLASS 2Address:1548 Hallet Ct NW Nora Poitras/Ofelia Gar

Telephone:(503) 798-5610

Yes

MEDICAID No



Ca5 Smoking:No

Prov Number:520657

CLASS 2Address:2233 Juneau Ct S Cindra Stover & Veroni

Telephone:(503) 798-5610

Yes

MEDICAID No



Ca5 Smoking:No

Prov Number:521644

CLASS 2Address:4322 Trapper Dr NE Fugate, Dickerson, Gon

Telephone:(503) 798-5610

No

MEDICAID No

Premier Care HomesHibner, Margie, Lefore, Janell


Ca4 Smoking:Outside

Prov Number:503040

CLASS 2Address:17633 Powers Crk Lp NE

Telephone:(503) 873-2305

Yes

MEDICAID Yes

Hovland's Care HomeHovland, Gayla

Text77:Silverton OR 97381

Ca5 Smoking:Outside

Prov Number:525490

CLASS 2Address:11944 SE Boyer Rd

Telephone:(503) 472-4496

No

MEDICAID Yes

Hudson Haven LLCHudson, Michael & Billie


Ca5 Smoking:Outside

Prov Number:500211

CLASS 2Address:331 Lone Oaks Loop Angela Fowler/Danesha

Telephone:(503) 873-7116

Yes

MEDICAID No

Lone Oaks Care Home, Inc.Humphries, Dee

Text77:Silverton OR 97381 1

Ca5 Smoking:Outside

Prov Number:521767

CLASS 3Address:3001 Windsor Avenue NE

Telephone:(503) 581-0393

Yes

MEDICAID Yes

Windsor Place Inc. - Windsor HouseHunter, Susan



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:Outside

Prov Number:521768


Telephone:(503) 581-0393

Yes

MEDICAID Yes

Windsor Place Inc. - Mason HouseHunter, Susan


Ca5 Smoking:Outside

Prov Number:521769


Telephone:(503) 581-0393

Yes

MEDICAID Yes

Windsor Place Inc - Regency HouseHunter, Susan


Ca5 Smoking:No

Prov Number:526691

CLASS 2Address:4392 Coloma Dr SE

Telephone:(503) 362-5409

Yes

MEDICAID Yes

The Shepherd's HomeHux, Brenda


Ca5 Smoking:Outside

Prov Number:521495

CLASS 2Address:3285 Glendale Ave NE

Telephone:(503) 581-6870

No

MEDICAID Yes

Ibanez, Bianca


Ca5 Smoking:No

Prov Number:526575

CLASS 3Address:7351 Macleay Rd SE

Telephone:(503) 589-1100

Yes

MEDICAID Yes

Paradise Home CareIonita, Lucica


Ca5 Smoking:Outside

Prov Number:507836

CLASS 2Address:1185 Barnes Rd SE Jay Holcer

Telephone:(503) 999-8159

Yes

MEDICAID Yes

AMAZING GRACE CARE HOMES INCJemison, Sherri


Ca5 Smoking:Outside

Prov Number:514731

CLASS 2Address:1195 Barnes Rd SE Meri McIntyre

Telephone:(503) 999-8159

Yes

MEDICAID Yes

Amazing Grace Care Homes LLCJemison, Sherri


Ca5 Smoking:Outside

Prov Number:511482

CLASS 2Address:1205 Barnes Rd SE Yvonne Stout

Telephone:(503) 999-8159

Yes

MEDICAID Yes

Amazing Grace Care Homes Inc.Jemison, Sherri


Ca5 Smoking:Outside

Prov Number:508779

CLASS 2Address:325 Silver Hills Circle SE Traci Grendler

Telephone:(503) 999-8159

Yes

MEDICAID Yes

AMAZING GRACE CARE HOMES INCJemison, Sherri


Ca5 Smoking:No

Prov Number:501807

CLASS 2Address:1085 Kathy Way South Barbara Burnell & Amb

Telephone:(503) 559-4104

Yes

MEDICAID No

Windflower EstatesJohnson, Kathy


Ca5

1

Smoking:No

Prov Number:500175

CLASS 2Address:4919 Flintlock Dr NE Tanna Fowler & Victoria

Telephone:(503) 559-4104

Yes

MEDICAID No

Windflower EstatesJohnson, Kathy


Ca5 Smoking:No

Prov Number:577853

CLASS 2Address:1534 Aztec Dr Gana Davis

Telephone:(503) 989-1463

Yes

MEDICAID Yes

Kahee, Rhonda



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca3 Smoking:No

Prov Number:517186

CLASS 2Address:418 Pleasant Avenue

Telephone:(503) 325-5731

Yes

MEDICAID Yes

Pleasant Living Adult Foster HomeKahle, Brent & Renee


Ca5 Smoking:Outside

Prov Number:524121

CLASS 2Address:3080 Grand Ave

Telephone:(503) 741-3021

Yes

MEDICAID No

Grand Adult Foster Home LLCKancharla, Joseph & Krupara


Ca3 Smoking:No

Prov Number:512953

CLASS 2Address:531 Craven St. N

Telephone:(503) 838-1476

Yes

MEDICAID Yes

Kaymora AFHKaton, Della, Mora, Malinda

Text77:Monmouth OR 97361

Ca5 Smoking:Outside

Prov Number:526217

CLASS 2Address:983 Burley Hill Dr NW Katricia Brenner

Telephone:(503) 339-7493

Yes

MEDICAID Yes

Amore Care LLCKostioutchenko, Angela


Ca5 Smoking:No

Prov Number:525256

CLASS 2Address:805 Fir Cone Dr NE

Telephone:(503) 463-6508

Yes

MEDICAID Yes

LARISA KRAVCHUK AFH LLCKravchuk, Larisa


Ca4 Smoking:Outside

Prov Number:510146

CLASS 3Address:175 Friendship Ave. SE

Telephone:(503) 378-7313

Yes

MEDICAID Yes

Larsen, Tina


Ca5 Smoking:Outside

Prov Number:524820

CLASS 2Address:2336 Baxter Rd SE Tamara Partain

Telephone:(901) 326-3521

Yes

MEDICAID No

Quality Care Homes, LLCLeavell, Scott


Ca5

1

Smoking:Outside

Prov Number:517499

CLASS 2Address:4539 47th Ave NE

Telephone:(503) 508-4369

Yes

MEDICAID Yes

Wheelin' AngelsLee, Merrilyn "Sue"


Ca5 Smoking:Yes

Prov Number:526510

CLASS 2Address:4802 Noren Ave

Telephone:(503) 991-5473

Yes

MEDICAID Yes

Lewitzke, Coral


Ca5

1

Smoking:No

Prov Number:515802

CLASS 2Address:380 Stellers Eagle St. NW

Telephone:(503) 391-7249

Yes

MEDICAID No

Golden Care Adult Foster HomeMadlangbayan, Divina


Ca5 Smoking:Outside

Prov Number:526289

CLASS 2Address:4042 Gardner Rd SE Adrianna Bodda

Telephone:(503) 991-5822

Yes

MEDICAID Yes

Benevolence Care Home LLCMaldonado, Alisha


Ca5 Smoking:Outside

Prov Number:510342

CLASS 2Address:4415 Lone Oak Rd SE

Telephone:(503) 581-1217

Yes

MEDICAID Yes

Jan's Care HomeMartinez, Jan & Jon



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:Yes

Prov Number:525330

CLASS 2Address:1628 NW Madrona Ct

Telephone:(503) 434-8650

Yes

MEDICAID Yes

Madrona Care HomeMoon, Mary


Ca2 Smoking:Outside

Prov Number:526274

CLASS 3Address:390 59th Ave SE

Telephone:(503) 983-9129

Yes

MEDICAID YES

Amorous Care Home LLCMusachia, Sara


Ca5 Smoking:Outside

Prov Number:524502

CLASS 2Address:52 NW Birch Ct

Telephone:(503) 861-8388

Yes

MEDICAID Yes

Radiant Care LLCNakka, Chandini

Text77:Warrenton OR 97146

Ca5 Smoking:Outside

Prov Number:525461

CLASS 2Address:447 N Main Sujay Nakka

Telephone:(503) 861-8634

Yes

MEDICAID Yes

Radiant Care AFH LLCNakka, Vijaya

Text77:Warrenton OR 97146

Ca2 Smoking:No

Prov Number:521677

CLASS 2Address:2738 Maranatha Ct SE

Telephone:(503) 391-2920

Yes

MEDICAID Yes

Camelias Place LLCNauta, Camelia

Text77:Turner OR 97392

Ca5 Smoking:No

Prov Number:525663

CLASS 2Address:4235 Wheat Court NE

Telephone:(503) 758-3194

Yes

MEDICAID Yes

Sage Adult Foster Homes LLCNoel, Amelie


Ca5 Smoking:No

Prov Number:506032

CLASS 3Address:1020 Elm St NW

Telephone:(503) 588-3600

Yes

MEDICAID Yes

Edward F. Tokarski HomeNorton, Sharon, Rose, Shanti


Ca5 Smoking:Outside

Prov Number:525509

CLASS 2Address:147 NW Douglas St

Telephone:(503) 623-8976

Yes

MEDICAID Yes

L & L Adult Foster Home, LLCPadgett, Marlene


Ca4 Smoking:Outside

Prov Number:511155

CLASS 2Address:4323 Sylvia Ct SE

Telephone:(503) 375-7772

Yes

MEDICAID Yes

Padilla, Mirna


Ca4 Smoking:No

Prov Number:522387

CLASS 2Address:629 NW Baker Creek Rd

Telephone:(503) 857-0025

Yes

MEDICAID Yes

Joyful Heart Care HomePagoso, Ivyjoy


Ca5 Smoking:No

Prov Number:516121

CLASS 2Address:632 Cummings Lane N

Telephone:(503) 393-3272

Yes

MEDICAID Yes

GOLDEN YEARSPawlowski, Susan


Ca4 Smoking:

Prov Number:525616

CLASS 2Address:242 Idell Ct SE

Telephone:(503) 363-8164

Yes

MEDICAID Yes

Preston, Kristen



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:Outside

Prov Number:521149

CLASS 2Address:680 Locust Ct

Telephone:(503) 749-1526

No

MEDICAID Yes

AJK Care HomeRead, Annette

Text77:Aumsville OR 97325

Ca3

1

Smoking:Outside

Prov Number:502122

CLASS 2Address:847 Lantana Lane

Telephone:(503) 792-3806

Yes

MEDICAID Yes

The Reagan Home AFCReagan, Loretta

Text77:Gervais OR 97026

Ca5 Smoking:Outside

Prov Number:516458

CLASS 2Address:1665 Berry St. SE Brenda Miller

Telephone:(503) 551-3567

Yes

MEDICAID Yes

Berry CareReynosa, Rachenda


Ca5 Smoking:No

Prov Number:521632

CLASS 2Address:2730 Fisher Rd NE

Telephone:(503) 581-6330

Yes

MEDICAID Yes

Skyway Heavenly HomesRobinson, Connie


Ca5 Smoking:No

Prov Number:524745

CLASS 3Address:2145 NW Westwind Dr

Telephone:(503) 883-9523

Yes

MEDICAID No

Sunset Hill Care HomeRogers, Maria


Ca5 Smoking:Outside

Prov Number:514298

CLASS 2Address:1323 C St Robin Martin

Telephone:(503) 838-2747

Yes

MEDICAID Yes

Maplewood Care Home LLCRowland, Gayle

Text77:Independence OR 97351

Ca5 Smoking:Outside

Prov Number:526453

CLASS 2Address:940 Fairview Ave. SE

Telephone:(503) 588-7470

Yes

MEDICAID Yes

All Seasons Care, IncRuiz, Fabiola


Ca5 Smoking:Outside

Prov Number:506385

CLASS 2Address:837 Lantana Lane NE

Telephone:(503) 792-3283

Yes

MEDICAID Yes

Ruiz, Juan T.


Ca5 Smoking:Yes

Prov Number:525604

CLASS 2Address:10052 Lake Dr SE

Telephone:(503) 581-3500

Yes

MEDICAID Yes

Ankeny Hill Manor LLCSabin, Clifford, Sabin, Bonita


Ca4 Smoking:Yes

Prov Number:526615

CLASS 1Address:5080 10th Place S

Telephone:(503) 363-6886

No

MEDICAID Yes

10th Place Cottage AFH LLCSabin, Jared, Sabin, Charlene


Ca4 Smoking:Yes

Prov Number:526097

CLASS 3Address:4465 Great Plains Dr. NE

Telephone:(503) 881-5664

No

MEDICAID Yes

Comfort & Care HomesSalazar, Regina, Salazar, Eric


Ca5 Smoking:No

Prov Number:516123

CLASS 2Address:550 Millstream Woods

Telephone:(503) 767-6300

Yes

MEDICAID Yes

Mountain Creek Care HomeSalinas, Paola



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca5 Smoking:Outside

Prov Number:526507

CLASS 2Address:1390 Clay St NE Candelaria Domingo

Telephone:(971) 600-3146

Yes

MEDICAID Yes

Happy Hearts Adult Foster CareScotland, Elana


Ca5 Smoking:Outside

Prov Number:522303

CLASS 2Address:1096 Hoffman Rd NE

Telephone:(503) 393-2202

Yes

MEDICAID Yes

American Dream Care Home LLCShcheglyak, Iryna


Ca5 Smoking:Outside

Prov Number: c

CLASS 02Address:772 Chemawa Rd N Irina Kaya

Telephone:(971) 338-8522

Yes

MEDICAID Yes

Lina’s Adult Foster HomeShimalin, Akulina


Ca5 Smoking:No

Prov Number:524107

CLASS 2Address:4598 Ward Dr NE

Telephone:(503) 409-5555

No

MEDICAID Yes

House of Troy LLCSikel, Charlene


Ca5 Smoking:Outside

Prov Number:523759

CLASS 2Address:4722 Oak Park Drive NE Shanon Smith

Telephone:(503) 584-1631

No

MEDICAID Yes

Arbor Home CareSnegireff, Ana


Ca5 Smoking:Outside

Prov Number:521486

CLASS 2Address:12398 Portland Rd. Christina Robinson

Telephone:(503) 792-7042

Yes

MEDICAID Yes

Sobrak, Karen


Ca2 Smoking:No

Prov Number:533013

CLASS 2Address:486 Winding Ct SE

Telephone:(503) 363-6179

No

MEDICAID Yes

Riverdale HouseSteel-Miller, Jon


Ca4 Smoking:

Prov Number:526241

CLASS 2Address:3515 Scenic View Dr SE

Telephone:(503) 991-5333

yes

MEDICAID Yes

Taylor, Ann


Ca5 Smoking:Outside

Prov Number:525062

CLASS 1Address:5540 8th Ave SE

Telephone:(503) 581-7515

Yes

MEDICAID Yes

Thompson, Colleen


Ca5 Smoking:No

Prov Number:523447

CLASS 2Address:7460 O'Neil Rd. NE

Telephone:(503) 580-9241

Yes

MEDICAID Yes

Adoracion Adult Foster HomeTompkins, Elenita (Ellen)


Ca5 Smoking:Outside

Prov Number:526705

CLASS 2Address:603 SW Arthur St

Telephone:(971) 706-2135

Yes

MEDICAID Yes

MC and Associates LLCTorio & Morgan, Cindy & Marj

Text77:McMinnville OR 97128 1

Ca5 Smoking:Yes

Prov Number:565270

CLASS 2Address:4754 18th Ave NE Claudia Leal

Telephone:(503) 390-2771

Yes

MEDICAID Yes

Brenda's Care HomeTorres, Brenda



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca4 Smoking:No

Prov Number:512109

CLASS 2Address:26430 SW Regia Dr

Telephone:(503) 843-4724

Yes

MEDICAID Yes

Tucker Adult Care HomeTucker, Tammy T.

Text77:Sheridan OR 97378

Ca5 Smoking:Outside

Prov Number:526865

CLASS 3Address:1471 Jonmart Ave SE

Telephone:(503) 371-2874

Yes

MEDICAID Yes

Love Hope AFH IncTusse, Dureti


Ca5

2

Smoking:No

Prov Number:509198

CLASS 3Address:480 Workman Drive

Telephone:(503) 981-9141

Yes

MEDICAID Yes

Woodburn Adult Foster HomeVanPelt, Janelle

Text77:Woodburn OR 97071 1

Ca5 Smoking:Outside

Prov Number:524484

CLASS 2Address:4051 Alderbrook Ave SE

Telephone:(503) 363-2911

Yes

MEDICAID Yes

Bella Vista Care HomeVasoc-Szabo, Cristina


Ca5 Smoking:No

Prov Number:521675

CLASS 2Address:1610 Church St. NE

Telephone:(503) 540-5814

Yes

MEDICAID Yes

Admila AFHVityukov, Valentina


Ca3

1

Smoking:Outside

Prov Number:515530

CLASS 2Address:351 SW Birch St.

Telephone:(503) 831-0096

Yes

MEDICAID Yes

Our Redeemer's Care, Inc.Waddell, Dawn & Larry


Ca5

1

Smoking:No

Prov Number:525110

CLASS 3Address:555 Misty Hill Lane SE

Telephone:(503) 362-2391

Yes

MEDICAID yes

House on Haven HillWalton, Nancy


Ca5 Smoking:Yes

Prov Number:526556

CLASS 02Address:2505 Brown Rd NE

Telephone:(503) 871-7385

No

MEDICAID Yes

Watson, Glen


Ca5 Smoking:Outside

Prov Number:525830

CLASS 2Address:1637 Hummingbird Ln Susan LoSciuto

Telephone:(503) 769-3040

Yes

MEDICAID Yes

Open Arms Adult Care LLC DBA Retha'sWheeler-McKenzie, Erin


Ca5 Smoking:Outside

Prov Number:539200

CLASS 3Address:3523 Jefferson-Marion Rd

Telephone:(541) 378-7587

Yes

MEDICAID Yes

Whittington, Cheryl

Text77:Jefferson OR 97352

Ca5 Smoking:No

Prov Number:526281

CLASS 2Address:1453 Narcissus Ct NW

Telephone:(541) 556-4495

Yes

MEDICAID Yes

Aloha Care Home AFH LLCWilliams, Deanna


Ca5 Smoking:No

Prov Number:513925

CLASS 2Address:5060 Barnes Court SE Maria Truett

Telephone:(971) 599-5512

Yes

MEDICAID Yes

Honored CitizensWilliams, Deanna M.



of 13


PROVIDER NAME

ADDRESS


WHEELCHAI

CAPACITY

SMOKING

CLASS

CONTRACT

PROVIDER #

DC RB

Ca3 Smoking:Outside

Prov Number:523370

CLASS 2Address:5786 59th Ct SE

Telephone:(503) 585-8723

No

MEDICAID Yes

Golden Years Senior HomeWomack, Janice


Ca5 Smoking:Outside

Prov Number:511802

CLASS 2Address:10752 Leverman Rd SE

Telephone:(503) 749-2710

Yes

MEDICAID Yes

Oak Valley Farms IncWright, Nikki & Robert

Text77:Aumsville OR 97325 2

Ca5 Smoking:Outside

Prov Number:507338

CLASS 2Address:10772 Leverman Rd SE

Telephone:(503) 749-2710

Yes

MEDICAID Yes

Oak Valley Farms IWright, Nikki & Robert

Text77:Aumsville OR 97325 2


of 13


6/4/2018 adult foster homes: clatsop, marion,...

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