SEASIDE SENIOR LIVING LLC (NPI# 1285751081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285751081 |
| Entity Type | Organization |
| Organization Name | SEASIDE SENIOR LIVING LLC |
| Other Organization Name | NECANICUM VILLAGE ASSISTED LIVING & MEMORY CARE COMMUNITY |
| Practice Address |
2500 South Roosevelt Dr Seaside OR 97138-6366 |
| Mailing Address |
Po Box 3006 Salem OR 97302-0006 |
| Practice Telephone | 5037380900 |
| Mailing Telephone | 5033759016 |
| Mailing Fax Number | 5034851279 |
| Enumeration Date | 2007-03-25 |
| Last Update Date | 2008-07-14 |
| Authorized Official Name | JON M HARDER (MANAGER) |
| Authorized Official Telephone | 5034854600 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | 1401008247 | OR | Nursing & Custodial Care Facilities |
| N | 311500000X | Alzheimer Center (Dementia Center) | 1701870142 | OR | Nursing & Custodial Care Facilities |
| Y | 310400000X | Assisted Living Facility | OR | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| NECANICUM VILLAGE Assisted Living & Memory Care Community | Doing Business As Name - Organization |
| Street Address |
2500 SOUTH ROOSEVELT DR |
| City | SEASIDE |
| State | OR |
| Zip Code | 97138-6366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881238376 | Abigail Mcneil | Social Worker | 1150 N Roosevelt Dr., Suite 104, Seaside, OR 97138 | 2019-10-29 |
| 1124564455 | Shelby James | Massage Therapist | 620 S Holladay Dr Ste 3, Seaside, OR 97138 | 2017-01-10 |
| 1699151902 | Joseph Alphonse Sutton | Pharmacist | 79380 Highway 202, Seaside, OR 97138 | 2015-08-10 |
| 1487047197 | Seaside Dental Clinic | Dentist | 729 S Holladay Drive, Seaside, OR 97138 | 2015-03-05 |
| 1215331020 | Jessica Jones | Massage Therapist | 1601 S. Roosevelt, Seaside, OR 97138 | 2014-10-22 |
| 1952735987 | Derk Penrod | Pharmacist | 401 S Roosevelt, Seaside, OR 97138 | 2013-08-27 |
| 1194166025 | Scott Allen Kafader | Pharmacist | 1150 N. Roosevelt Dr., Suite 104, Seaside, OR 97138 | 2013-07-08 |
| 1326391459 | Addiction Medicine Consulting | Substance Abuse Rehabilitation Facility | 1325 North Holladay Dr., Seaside, OR 97138 | 2012-10-26 |
| 1548552938 | Robert W Olson | Pharmacist | 313 S Rosevelt Drive, Seaside, OR 97138 | 2011-05-04 |
| 1831395144 | Delores Swigert Sullivan | Social Worker | 564 Pacific Way, Gearhart, OR 97138 | 2007-06-23 |
| Find all providers in zip 97138 | ||||
| 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 |
|---|---|---|---|---|
| 1275847691 | Emeritus Corporation | Assisted Living Facility | 2500 S Roosevelt Dr, Seaside, OR 97138-6366 | 2010-07-27 |
| 1306001474 | Forest Drive Operations, LLC | Assisted Living Facility | 101 Forest Dr, Seaside, OR 97138-7867 | 2008-07-28 |
| 1346360344 | Neawanna By The Sea | Assisted Living Facility | 20 N Wahanna Rd, Seaside, OR 97138-7862 | 2007-03-31 |
| 1578961413 | Necanicum Operations, LLC | Assisted Living Facility | 2500 S Roosevelt Dr, Seaside, OR 97138-6366 | 2014-12-09 |
| 1205268117 | Fc Ranger Ops Neawanna (or), LLC | Assisted Living Facility | 20 N Wahanna Rd, Seaside, OR 97138-7862 | 2013-08-01 |
| 1053625251 | Emeritus Corporation | Assisted Living Facility | 2500 S Roosevelt Dr, Seaside, OR 97138-6366 | 2010-07-29 |
| 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 |
| 1255958120 | Elderberry Square Community, LLC | Assisted Living Facility | 3321 Oak St, Florence, OR 97439-9515 | 2020-06-26 |
| 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 |
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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.