SUMMERPLACE ASSISTED LIVING LLC (NPI# 1164559282) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164559282 |
| Entity Type | Organization |
| Organization Name | SUMMERPLACE ASSISTED LIVING LLC |
| Other Organization Name | SUMMERPLACE ASSISTED LIVING COMMUNITY |
| Practice Address |
15727 Ne Russell St Portland OR 97230-8222 |
| Mailing Address |
7700 Ne Parkway Dr Suite 300 Vancouver WA 98662-6648 |
| Practice Telephone | 5032529361 |
| Practice Fax Number | 5032529405 |
| Mailing Telephone | 3607357155 |
| Mailing Fax Number | 3607359416 |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GREGORY J VISLOCKY (MANAGING MEMBER) |
| Authorized Official Telephone | 3607357155 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | OR | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 502073 | 05 |
| Other Name | Type Code |
|---|---|
| Summerplace Assisted Living Community | Doing Business As Name - Organization |
| Street Address |
15727 NE RUSSELL ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97230-8222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407473317 | Summervent, LLC | Assisted Living Facility | 15727 Ne Russell St, Portland, OR 97230-8222 | 2020-06-26 |
| 1437669116 | Premere Rehab, LLC | Occupational Therapist | 15727 Ne Russell St, Portland, OR 97230-8222 | 2017-10-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932687233 | Timisha K Wilson | Social Worker | 12505 Ne Halsey St, Portland, OR 97230 | 2018-07-30 |
| 1356828768 | Sally Gail Logan | Pharmacist | 5725 Ne 138th Avenue, Portland, OR 97230 | 2018-07-27 |
| 1063937951 | Marley Elizabeth Small | Counselor | 1507 Ne 122nd Ave., Portland, OR 97230 | 2017-08-11 |
| 1447771316 | Shadab Nasreen Aijazi | Pathology | 5220 Ne 122nd Avenue, Portland, OR 97230 | 2017-06-30 |
| 1104378199 | Derek Andrus | Pharmacist | 5717 Nw 138th, Portland, OR 97230 | 2016-10-26 |
| 1164972675 | Rachael Anderson | Adult Companion | 423 Ne 160th Ave #11, Portland, OR 97230 | 2016-10-07 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1649622473 | Sara Mcgroarty | Counselor | 17710 Ne Halsey Street, Portland, OR 97230 | 2016-07-05 |
| 1346699949 | Steven D Stanton | Counselor | 1022 Ne 181st Ave, C1, Portland, OR 97230 | 2016-06-06 |
| 1215390091 | The Wallace Medical Concern | Clinic/Center | 18139 Ne Couch Street, Portland, OR 97230 | 2016-03-30 |
| Find all providers in zip 97230 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384576 | Pacifica Calaroga Terrace LLC | Assisted Living Facility | 1400 Ne 2nd Ave, Portland, OR 97232-1148 | 2020-10-22 |
| 1366068959 | Harvest Homes Inc | Assisted Living Facility | 6921 N Roberts Ave, Portland, OR 97203-6385 | 2020-06-19 |
| 1700408010 | Senior Haven LLC | Assisted Living Facility | 12140 Se Foster Rd, Portland, OR 97266-4043 | 2020-05-08 |
| 1508407016 | Blandina Chitalah | Assisted Living Facility | 342 Woodford St Unit 1, Portland, ME 04103-5608 | 2019-10-05 |
| 1962058024 | Bright Lantern Home Care | Assisted Living Facility | 14 Powsland St Apt 2, Portland, ME 04102-2622 | 2019-08-14 |
| 1750837597 | Providence Elderplace | Assisted Living Facility | 16430 Ne Hoyt St, Portland, OR 97230 | 2016-08-31 |
| 1164845921 | Russellville IIi LLC | Assisted Living Facility | 23 Se 103rd Ave, Portland, OR 97216 | 2014-01-30 |
| 1215368840 | The Meadows At Halltown, Inc. | Assisted Living Facility | 711 Halltown Rd, Portland, TN 37148-9071 | 2013-12-08 |
| 1811219397 | Richland Place Senior Living | Assisted Living Facility | 201 Richland Lake Dr, Portland, TN 37148-1775 | 2010-02-24 |
| 1477881951 | Fallbrook Residential Care Facility, Inc. | Assisted Living Facility | 418 Ray St, Portland, ME 04103-3934 | 2009-11-23 |
| Find all providers in PORTLAND | ||||
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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.