STAYTON SW ASSISTED LIVING LLC (NPI# 1689791485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689791485 |
| Entity Type | Organization |
| Organization Name | STAYTON SW ASSISTED LIVING LLC |
| Other Organization Name | LAKESIDE ASSISTED LIVING COMMUNITY |
| Practice Address |
2201 3rd Avenue Stayton OR 97383-1388 |
| Mailing Address |
Po Box 3006 Salem OR 97302-0006 |
| Practice Telephone | 5037693200 |
| 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 | 1769313990 | OR | Nursing & Custodial Care Facilities |
| Y | 310400000X | Assisted Living Facility | OR | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Lakeside Assisted Living Community | Doing Business As Name - Organization |
| Street Address |
2201 3RD AVENUE |
| City | STAYTON |
| State | OR |
| Zip Code | 97383-1388 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487204228 | Bishop Stayton Lessee LLC | Assisted Living Facility | Elmcroft of Stayton, 2201 3rd Ave., Stayton, OR 97383 | 2019-09-13 |
| 1972097699 | Nathan Daniel Hoover | Pharmacist | 1401 North 10th Ave, Stayton, OR 97383 | 2018-06-16 |
| 1801211560 | Maria A Fife | Nurse Practitioner | 1095 N 1st Ave, Stayton, OR 97383 | 2014-03-04 |
| 1467771295 | Jennifer Clorinda Brewer | Obstetrics & Gynecology | 1373 N. 10th Ave, Stayton, OR 97383 | 2010-05-18 |
| 1578785622 | Lakeside Cottages | Assisted Living Facility | #310-369 Wildflower Drive, Stayton, OR 97383 | 2007-05-02 |
| 1215099627 | Ritchie B Gooch | Family Medicine | 1377 N 10th Avenue, Stayton, OR 97383 | 2006-12-14 |
| 1710932710 | Promotion Advanced Functional Rehab LLC | Physical Therapy Assistant | 601 N 1st Ave, Stayton, OR 97383 | 2006-05-24 |
| 1508352279 | Madison Taylor Eymann | Physical Therapist | 1750 Wilco Rd, Stayton, OR 97383 | 2018-07-06 |
| 1154814390 | Santiam Memorial Hospital | Clinic/Center | 1371 N 10th Ave, Stayton, OR 97383 | 2018-06-12 |
| 1912413147 | Santiam Memorial Hospital | Clinic/Center | 1369 N 10th Ave, Stayton, OR 97383 | 2017-12-26 |
| Find all providers in zip 97383 | ||||
| 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 |
|---|---|---|---|---|
| 1487204228 | Bishop Stayton Lessee LLC | Assisted Living Facility | Elmcroft of Stayton, 2201 3rd Ave., Stayton, OR 97383 | 2019-09-13 |
| 1932412434 | Emeritus Corporation | Assisted Living Facility | 2201 N 3rd Ave, Stayton, OR 97383-1298 | 2010-07-26 |
| 1578785622 | Lakeside Cottages | Assisted Living Facility | #310-369 Wildflower Drive, Stayton, OR 97383 | 2007-05-02 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.