Organization Active NPI

Cordova Senior Living, LLC

Doing business as Cordova Estates Assisted Living and Memory Care

  • Assisted Living Facility
  • Cordova, TN
National Provider Identifier
1013138122
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
CORDOVA SENIOR LIVING, LLC
Doing business as
Cordova Estates Assisted Living and Memory Care
Practice address
1535 Appling Care Lane
Cordova, TN 38018
Phone
(901) 377-7500
NPI assigned
May 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jon Harder
Title
Manager
Phone
(503) 485-4600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

1535 Appling Care Lane
Cordova, TN 38018

Mailing address

3723 Fairview Industrial Dr SE
Salem, OR 97302
Phone (503) 485-4600

Other names 1

  • Cordova Estates Assisted Living and Memory Care Doing business as

National Provider Directory

National Provider Directory

Locations

1535 Appling Care Ln
Cordova, TN 38016
Phone (901) 377-7500

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013138122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3723 FAIRVIEW INDUSTRIAL DR SE",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "503-485-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 APPLING CARE LANE",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "38018",
            "telephone_number": "901-377-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORDOVA SENIOR LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cordova Estates Assisted Living and Memory Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cordova, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.