ELDERBERRY SQUARE COMMUNITY, LLC (NPI# 1255958120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1255958120 |
Entity Type | Organization |
Organization Name | ELDERBERRY SQUARE COMMUNITY, LLC |
Practice Address |
3321 Oak St Florence OR 97439-9515 |
Practice Telephone | 5414752273 |
Mailing Telephone | 5414752273 |
Enumeration Date | 2020-06-26 |
Last Update Date | 2020-06-26 |
Authorized Official Name | CARL ALLEN MASON (DIRECTOR OF OPERATIONS) |
Authorized Official Telephone | 5038265190 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OR | 522229 | 05 | |
OR | 522211 | 05 |
Other Name | Type Code |
---|---|
New Friends Memory and Residential Care of Florence | Doing Business As Name - Organization |
Entity Type | Entity Name | Entity Address |
---|---|---|
Oregon Corporations, Companies and Business Names | ELDERBERRY SQUARE COMMUNITY, LLC | 25260 Sw Parkway Ave Suite B, Wilsonville, OR 97070 |
Street Address |
3321 OAK ST |
City | FLORENCE |
State | OR |
Zip Code | 97439-9515 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417586488 | Kelcie-may S Toledo | Pharmacist | 700 Us-101, Florence, OR 97439 | 2020-04-02 |
1144875444 | Steven Mee | Dentist | 1225 Us - 101, Florence, OR 97439 | 2019-08-05 |
1164944351 | Karie James | Massage Therapist | 2010 11th St, Florence, OR 97439 | 2017-07-10 |
1205266046 | Deborah Lynne Grigsby | Counselor | 1490 1st Street, Unit #1, Florence, OR 97439 | 2013-11-14 |
1811247398 | Luke Henry | Occupational Therapist | 1951 East 21st Street, Florence, OR 97439 | 2012-09-12 |
1144589102 | Ryan Charles Korando | Denturist | 1705 22nd Street, Florence, OR 97439 | 2012-05-11 |
1568728640 | Deborah Lynn Pasternak | Massage Therapist | 1495 8th Street, Suite C, Florence, OR 97439 | 2012-04-03 |
1275844185 | Serena Appel | Counselor | 1525 12th St Ste 8, Florence, OR 97439 | 2010-06-24 |
1669702056 | Monarch Medical Group LLC | Clinic/Center | 2775 Hwy 101, Suite B, Florence, OR 97439 | 2010-01-06 |
1871722231 | Aen Brauer | Social Worker | 1445 W 8th St, Florence, OR 97439 | 2009-07-07 |
Find all providers in zip 97439 |
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 |
---|---|---|---|---|
1386244002 | Gnpr, LLC | Assisted Living Facility | 1230 W 3rd St, Florence, CO 81226-9406 | 2020-10-30 |
1851790844 | 211-213 Ana Drive Operations LLC | Assisted Living Facility | 211 Ana Dr, Florence, AL 35630-1768 | 2014-08-15 |
1609203165 | Ec Florence Operations, LLC | Assisted Living Facility | 3006 Hoffmeyer Rd, Florence, SC 29501-7551 | 2013-09-30 |
1497958052 | Vnr Incorporated | Assisted Living Facility | 1004 6th St, Florence, SD 57235-2135 | 2007-06-08 |
1003972407 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 901 Broad St, Florence, NJ 08518-2813 | 2006-12-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861092520 | W2 Powell Valley, LLC | Assisted Living Facility | 4001 Se 182nd Ave, Gresham, OR 97030-5063 | 2020-10-30 |
1790384576 | Pacifica Calaroga Terrace LLC | Assisted Living Facility | 1400 Ne 2nd Ave, Portland, OR 97232-1148 | 2020-10-22 |
1023629805 | Barbara Mcvay | Assisted Living Facility | 50792 Huntington Rd, La Pine, OR 97739-9041 | 2020-08-13 |
1255959821 | Northwest Hc Cambridge Terrace (or) Operator Nt-hci, LLC | Assisted Living Facility | 2800 14th Ave Se, Albany, OR 97322-7079 | 2020-07-10 |
1639797103 | Northwest Hc Oak Park Or Operator Nt-hci LLC | Assisted Living Facility | 1400 Ne Rocky Ridge Dr, Roseburg, OR 97470-5673 | 2020-07-10 |
1912525486 | Northwest Hc Cascadia Village Or Operator Nt-hci LLC | Assisted Living Facility | 25117 Sw Parkway Ave Ste F, Wilsonville, OR 97070-9697 | 2020-07-10 |
1881211852 | Chancellor Health Care of California Ix, Inc. | Assisted Living Facility | 14550 Se Vista Ln, Milwaukie, OR 97267-1731 | 2020-06-25 |
1558987768 | Greenridge Estates Operating LLC | Assisted Living Facility | 4 Greenridge Dr, Lake Oswego, OR 97035-1400 | 2020-06-23 |
1952927121 | Oregon Alf, LLC | Assisted Living Facility | 15900 Se 82nd Dr, Clackamas, OR 97015-9502 | 2020-06-23 |
1881210136 | Lynn Ann Development, LLC | Assisted Living Facility | 1700 Kellenbeck Ave, Grants Pass, OR 97527-4251 | 2020-06-23 |
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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.