PACIFIC SENIOR CARE, LLC (NPI# 1144247115) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144247115 |
| Entity Type | Organization |
| Organization Name | PACIFIC SENIOR CARE, LLC |
| Other Organization Name | GRESHAM POST ACUTE CARE AND REHABILITATION |
| Practice Address |
405 Ne 5th St Gresham OR 97030 |
| Mailing Address |
127 Ne 102nd Ave Ste A Portland OR 97220 |
| Practice Telephone | 5036665600 |
| Practice Fax Number | 5039078911 |
| Mailing Telephone | 5032547923 |
| Mailing Fax Number | 5037649974 |
| Enumeration Date | 2006-07-16 |
| Last Update Date | 2019-07-25 |
| Authorized Official Name | PAUL REDHEAD (MANAGING MEMBER) |
| Authorized Official Telephone | 5419541937 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Gresham Post Acute Care and Rehabilitation | Doing Business As Name - Organization |
| Prestige Post-Acute and Rehabilitation Center - Gresham | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | PACIFIC SENIOR CARE, LLC | 405 Ne 5th Street, Gresham, OR 97030 |
| Street Address |
405 NE 5TH ST |
| City | GRESHAM |
| State | OR |
| Zip Code | 97030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144828567 | Rose Hernandez | Occupational Therapy Assistant | 405 Ne 5th St, Gresham, OR 97030-7345 | 2020-10-16 |
| 1033740899 | Sapphire At Gresham Rehab, LLC | Skilled Nursing Facility | 405 Ne 5th St, Gresham, OR 97030-7345 | 2020-01-30 |
| 1568925287 | Samuel Shepherd | Occupational Therapy Assistant | 405 Ne 5th St, Gresham, OR 97030-7345 | 2019-04-09 |
| 1881189751 | Rachel Karpelowitz | Physical Therapist | 405 Ne 5th St, Gresham, OR 97030-7345 | 2018-06-24 |
| 1689198814 | Claudia Anukam | Occupational Therapist | 405 Ne 5th St, Gresham, OR 97030-7345 | 2017-07-30 |
| 1437545399 | Adam Marlow | Occupational Therapist | 405 Ne 5th St, Gresham, OR 97030-7345 | 2015-04-07 |
| 1891004016 | Heather Lynne Eoff | Occupational Therapist | 405 Ne 5th St, Gresham, OR 97030-7345 | 2010-10-05 |
| 1346552395 | Tiffany Wildes | Speech-Language Pathologist | 405 Ne 5th St, Gresham, OR 97030-7345 | 2010-07-07 |
| 1164658944 | Rex Saludo | Physical Therapist | 405 Ne 5th St, Gresham, OR 97030-7345 | 2009-06-07 |
| 1013175819 | Ann Charise Luciano Cooper | Occupational Therapist | 405 Ne 5th St, Gresham, OR 97030-7345 | 2008-05-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174032312 | Tiffany Chen | Occupational Therapist | 304 Ne Hood Ave., Gresham, OR 97030 | 2017-09-20 |
| 1225568454 | Goldstar Vascular Access, Inc | Home Infusion | 2870 Ne Hogan Dr, Ste E #205, Gresham, OR 97030 | 2017-06-20 |
| 1861940454 | Jessica Morrow | Massage Therapist | 1748 Nw Fairview Dr., Gresham, OR 97030 | 2016-09-13 |
| 1033665898 | Bonita Baxter | Counselor | 400 Ne 7th Street, Gresham, OR 97030 | 2016-08-31 |
| 1710335484 | Ethan William Hoccom | Counselor | 1527 Ne Lamesa Place 17th St, Gresham, OR 97030 | 2016-06-02 |
| 1992159610 | Kathleen Kline, Lmt | Massage Therapist | 1217 Ne Burnside Road Suite 701-d, Gresham, OR 97030 | 2016-04-19 |
| 1215390109 | The Wallace Medical Concern | Nurse Practitioner | 254 Nw Burnside Road, Gresham, OR 97030 | 2016-03-30 |
| 1932568912 | Atchison Dialysis, LLC | Clinic/Center | 878 Nw Burnside Rd, Gresham, OR 97030 | 2016-02-18 |
| 1912374034 | Hilary Dawn Montgomery | Counselor | 1326 Nw Civic Dr # 5569, Gresham, OR 97030 | 2015-08-24 |
| 1992171730 | Melissa E Childs | Massage Therapist | 1217 Nw Burnside Rd Ste 701, Gresham, OR 97030 | 2015-08-17 |
| Find all providers in zip 97030 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144468505 | Todd Douglas Frary | Skilled Nursing Facility | 1941 Sw Lake Pl, Gresham, OR 97080-9798 | 2009-01-22 |
| 1881624112 | Rest Harbor Extended Care Center Inc. | Skilled Nursing Facility | 5905 Se Powell Valley Rd, Gresham, OR 97080-1919 | 2006-07-03 |
| 1225025216 | Village Health Care | Skilled Nursing Facility | 3955 Se 182nd Ave, Gresham, OR 97030-5036 | 2005-10-04 |
| 1033740899 | Sapphire At Gresham Rehab, LLC | Skilled Nursing Facility | 405 Ne 5th St, Gresham, OR 97030-7345 | 2020-01-30 |
| 1629224449 | Village Health Care I, LLC | Skilled Nursing Facility | 3955 Se 182nd Ave, Gresham, OR 97030-5036 | 2008-08-12 |
| 1790909786 | Regency Gresham Nursing & Rehabilitation Center LLC | Skilled Nursing Facility | 5905 Se Powell Valley Rd, Gresham, OR 97080-1919 | 2007-04-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565035 | Bkd Hillside Opco, LLC | Skilled Nursing Facility | 440 Nw Hillside Park Way, Mcminnville, OR 97128 | 2020-10-16 |
| 1689231383 | Marquis Companies I Inc | Skilled Nursing Facility | 410 Se Church Street, Sublimity, OR 97385 | 2019-05-29 |
| 1720528003 | Rashelle M Johnson | Skilled Nursing Facility | 2457 Ne Bobbi Pl, Prineville, OR 97754-9089 | 2017-03-06 |
| 1881133254 | Jessie Steele | Skilled Nursing Facility | 2693 Nw Crossing Dr, Bend, OR 97703-7347 | 2017-02-18 |
| 1063969988 | Set Op Co | Skilled Nursing Facility | 1220 20th St Se, 310, Salem, OR 97302-1205 | 2016-09-08 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| 1710336672 | Lauren Biamont | Skilled Nursing Facility | 5748 Smoketree Dr Se, Salem, OR 97306-1260 | 2016-06-10 |
| 1801278049 | Darrel A Decker | Skilled Nursing Facility | 350 8th Street, Lebanon, OR 97355 | 2015-06-24 |
| 1508250762 | West Linn Care Ctr Operating Co, LLC | Skilled Nursing Facility | 2330 Deok Rd., West Linn, OR 97068-3902 | 2015-03-26 |
| 1568871770 | Keizer River Operations, LLC | Skilled Nursing Facility | 450 Clagett Ct. N, Keizer, OR 97303-4400 | 2014-08-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.