EDMOND MEMORY CARE, LLC (NPI# 1871908913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871908913 |
| Entity Type | Organization |
| Organization Name | EDMOND MEMORY CARE, LLC |
| Other Organization Name | AUTUMN LEAVES OF EDMOND |
| Practice Address |
1001 S Bryant Ave Edmond OK 73034-5745 |
| Mailing Address |
545 E John Carpenter Fwy Suite 500 Irving TX 75062-3931 |
| Practice Telephone | 4053411450 |
| Practice Fax Number | 4053411451 |
| Mailing Telephone | 2148454500 |
| Mailing Fax Number | 2148454501 |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2014-06-27 |
| Authorized Official Name | CHRISTOPHER RIO (VP OF MANAGEMENT-SENIOR LIVING) |
| Authorized Official Telephone | 2148454500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 310400000X | Assisted Living Facility | AL5598-5598 | OK | Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| Autumn Leaves of Edmond | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oklahoma Business Registrations | EDMOND MEMORY CARE, LLC | 545 E. John Carpenter Freeway, Suite 500, Irving, TX 75062 |
| Street Address |
1001 S BRYANT AVE |
| City | EDMOND |
| State | OK |
| Zip Code | 73034-5745 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447172 | Saints Medical Group, LLC | Family Medicine | 2749 Progressive Dr, Suite B, Edmond, OK 73034 | 2020-11-06 |
| 1194339861 | Susan Haesook Kim | Pharmacist | 1400 2nd St, Edmod, Edmond, OK 73034 | 2020-09-01 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1043834849 | Paddington Place Lcc | Intermediate Care Facility, Mental Illness | 3225 French Park Drive, Suite 6, Edmond, OK 73034 | 2020-06-08 |
| 1083254932 | Purpose Healthcare Inc | Psychologist | 301 South Blvd, Suite 117, Edmond, OK 73034 | 2020-01-08 |
| 1740773662 | Healthcare Express, LLP | Family Medicine | 2300 E 2nd St, Edmond, OK 73034 | 2018-06-14 |
| 1427555713 | Sara Nicole Smith | Specialist/Technologist | 100 N University Drive, Attn: Athletic Training Room, Edmond, OK 73034 | 2018-04-12 |
| 1619475084 | Carissa Leigh Brackelsberg | Chiropractor | 3709 E 2nd St, Edmond, OK 73034 | 2018-01-31 |
| 1760996177 | Laurel Michelle Glendening | Physical Therapist | 3531 River Wood Lane, Edmond, OK 73034 | 2017-11-21 |
| 1134643380 | Keith S Quinn | Dentist | 3008 Peaceful Ln, Edmond, OK 73034 | 2017-07-31 |
| Find all providers in zip 73034 | ||||
| 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 |
|---|---|---|---|---|
| 1396279808 | Teal Creek Life Care Community Inc | Assisted Living Facility | 13501 N. Bryant Ave., Edmond, OK 73013 | 2017-04-12 |
| 1023284445 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 1500 N Santa Fe Ave, Edmond, OK 73003-3639 | 2008-05-06 |
| 1689840597 | Brookdale Senior Living Communities, Inc. | Assisted Living Facility | 116 W Danforth Rd, Edmond, OK 73003-5280 | 2008-05-01 |
| 1477919959 | Heartsworth Senior Living, LLC | Assisted Living Facility | 3325 French Park Dr, Edmond, OK 73034-7277 | 2016-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834482 | Red Bud Assisted Living LLC | Assisted Living Facility | 215 W Freeman Ave, Perkins, OK 74059-5600 | 2020-09-03 |
| 1295371466 | Belfair of Mcalester LLC | Assisted Living Facility | 802 Windsong Way, Mcalester, OK 74501 | 2019-11-22 |
| 1568855278 | Remember When Assisted Living, LLC | Assisted Living Facility | 5729 Nw 82nd St, Oklahoma City, OK 73132-4909 | 2015-03-05 |
| 1306243019 | Green Country Rehabilitation | Assisted Living Facility | 3535 Nw 58th St Ste 940, Oklahoma City, OK 73112-4802 | 2014-11-24 |
| 1508270380 | Heatheridge Health Care, LLC | Assisted Living Facility | 2130 S 85th East Ave, Tulsa, OK 74129-3066 | 2014-06-19 |
| 1740608660 | United Senior Properties of Shawnee, LLC | Assisted Living Facility | 789 E Country Grove Dr, Shawnee, OK 74804-1404 | 2014-03-29 |
| 1730507658 | United Senior Properties of Seminole, LLC | Assisted Living Facility | 2207 West Wrangler Blvd, Seminole, OK 74868 | 2014-03-29 |
| 1962837039 | Hugo Family Pharmacy | Assisted Living Facility | 420 E Jackson St, Hugo, OK 74743-4021 | 2013-09-09 |
| 1740526474 | Forest Hills Alf LLC | Assisted Living Facility | 4304 W Houston St, Broken Arrow, OK 74012-4519 | 2012-12-28 |
| 1629335773 | Grandwood Assisted Living, Lc | Assisted Living Facility | 2001 Sunrise Blvd, Grove, OK 74344-3617 | 2012-04-13 |
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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.