ELDERHEALTH & LIVING (NPI# 1912258443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912258443 |
| Entity Type | Organization |
| Organization Name | ELDERHEALTH & LIVING |
| Other Organization Name | SUMMIT SOUTH |
| Practice Address |
382 S 58th St Springfield OR 97478-7623 |
| Practice Telephone | 5417474858 |
| Practice Fax Number | 5417478314 |
| Mailing Telephone | 5417474858 |
| Mailing Fax Number | 5417478314 |
| Enumeration Date | 2012-09-24 |
| Last Update Date | 2012-09-24 |
| Authorized Official Name | MS. NANCY J KOLL (CFO) |
| Authorized Official Telephone | 5417474858 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 320800000X | Community Based Residential Treatment Facility, Mental Illness | 516389 | OR | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 516389 | 05 |
| Other Name | Type Code |
|---|---|
| Summit South | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | ELDERHEALTH & LIVING | 382 B South 58th St, Springfield, OR 97478 |
| Oregon Corporations, Companies and Business Names | ELDERHEALTH & LIVING MEMORY VILLAGE | 382 B South 58th St, Springfield, OR 97478 |
| Oregon Corporations, Companies and Business Names | ELDERHEALTH & LIVING VILLAGE | 382 B South 58th St, Springfield, OR 97478 |
| Street Address |
382 S 58TH ST |
| City | SPRINGFIELD |
| State | OR |
| Zip Code | 97478-7623 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588225155 | Mckenzie Dental Center | Dentist | 110 S. 59th St, Springfield, OR 97478 | 2019-06-25 |
| 1831691310 | Michael Ryan Odle | Psychologist | 36716 Oak Point Rd, Springfield, OR 97478 | 2018-03-01 |
| 1639612880 | Icco LLC | Clinic/Center | 5781 Main Street, Springfield, OR 97478 | 2016-11-21 |
| 1639529258 | Nate John Sutherland | Behavioral Analyst | 37770 Upper Creek Road, Springfield, OR 97478 | 2016-06-14 |
| 1457760134 | Leah Rybolt | Physical Therapist | 145 South 52nd Place, Springfield, OR 97478 | 2014-08-07 |
| 1972918423 | Loree Lynn Howard | Case Manager/Care Coordinator | 4145 Jasper Road, Springfield, OR 97478 | 2014-06-24 |
| 1245589753 | Sarah M Boothe | Doula | 870 S 46th St, Springfield, OR 97478 | 2012-08-30 |
| 1902155401 | Dani Maree Hill | Pharmacist | 5744 Main Street, Springfield, OR 97478 | 2012-08-30 |
| 1295005312 | Express Services Unlimited, Inc. | Non-emergency Medical Transport (VAN) | 37506 Hills Creek Road, Springfield, OR 97478 | 2012-01-05 |
| 1255524468 | Leeann D Fields | Licensed Practical Nurse | 3318 Lakeview Dr, Eugene, OR 97478 | 2007-08-21 |
| Find all providers in zip 97478 | ||||
| Taxonomy Code | 320800000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment Facility, Mental Illness |
| A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679073712 | Columbacare Services | Community Based Residential Treatment Facility, Mental Illness | 622 57th St, Springfield, OR 97478-6821 | 2018-02-15 |
| 1457594731 | Gateway Assisted Living, Inc. | Community Based Residential Treatment Facility, Mental Illness | 620 N Cloverleaf Loop, Springfield, OR 97477-1167 | 2009-04-15 |
| 1225155898 | Department of Mental Health | Community Based Residential Treatment Facility, Mental Illness | Three Rivers Irtp, 26 Ridgewood Ter, Springfield, MA 01105-1315 | 2007-03-26 |
| 1255455374 | Volunteers of America of Georgia | Community Based Residential Treatment Facility, Mental Illness | 102 Deer Rd, Springfield, GA 31329-9201 | 2007-03-16 |
| 1629119086 | Rainrock Treatment Center, LLC | Community Based Residential Treatment Facility, Mental Illness | 41496 Mckenzie Hwy, Springfield, OR 97478-8688 | 2007-02-09 |
| 1619066313 | Project Woman | Community Based Residential Treatment Facility, Mental Illness | 1316 E High St, Springfield, OH 45505-1195 | 2006-10-12 |
| 1487040424 | Columbiacare Services | Community Based Residential Treatment Facility, Mental Illness | 2211 Clear Vue Ln, Springfield, OR 97477-1373 | 2015-04-07 |
| 1225441256 | South Bay Mental Health Center | Community Based Residential Treatment Facility, Mental Illness | 140 High St, Springfield, MA 01199-1006 | 2014-06-06 |
| 1619308822 | Great Circle | Community Based Residential Treatment Facility, Mental Illness | 1212 W Lombard St, Springfield, MO 65806-2720 | 2013-12-13 |
| 1023263043 | Mental Health Centers of Central Illinois | Community Based Residential Treatment Facility, Mental Illness | 200 W Lake Dr, Building C, Springfield, IL 62703-4956 | 2008-11-18 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 97478 |
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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.