Roseburg Assisted Living LLC

Primary specialty

Point of ServiceTaxonomy code 305S00000X

Legal business name

ROSEBURG ASSISTED LIVING LLC

Doing business as

Oak Park Assisted Living Community

Practice address

3220 State St
Suite 200
Salem, OR 97301-6872

Phone

(503) 566-5715

NPI assigned

May 7, 2007

Last updated

Oct 4, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Kelley D Hamilton

Title

Ceo-Pres of Manager

Phone

(503) 566-5715

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oak Park Assisted Living Community Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1013120393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 NE ROCKY RIDGE DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974705673",
            "telephone_number": "541-464-5656",
            "fax_number": "541-677-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 STATE ST",
            "address_2": "SUITE 200",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973016872",
            "telephone_number": "503-566-5715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEBURG ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "HAMILTON",
        "authorized_official_first_name": "KELLEY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO-PRES OF MANAGER",
        "authorized_official_telephone_number": "503-566-5715",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "OR",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGISTRY #",
            "identifier": "647146-87",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Park Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Heather Rose
• Kyrai Ivy Ann Rose, PH.D.
• Renske Elvira Rose, MPT
• Roseanne Pikul, LMFT, LLC
• Glen Stanley Roseborough, MD
• Cheryl Marlene Rosecrans, CHW
• Rosemont Retirement & Assisted Living Community LLC (Rosemont Retirement & Assisted Living Community)
• Philip A. Rosen, MD
• Billie Jean Rosenblad, LPC
• Erika Marcia Rosin, BSN, RN

• Point of Service in Salem, OR
• Providers in Salem, OR by specialty
• Point of Service in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.