Roseburg Douglas Associates

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1273780464 Issued in OR

Legal business name

ROSEBURG DOUGLAS ASSOCIATES

Doing business as

Bridgewood Rivers Assisted Living

Practice address

1901 NW Hughwood Ave
Roseburg, OR 97470-5598

Phone

(541) 440-1914

Fax

(541) 440-9009

NPI assigned

Jun 20, 2008

Organization subpart

No

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

Authorized official

Name

Elizabeth Marie Moss

Title

Director of Risk Management

Phone

(503) 588-2725

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Bridgewood Rivers Assisted Living Doing business as

Locations

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1023279155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE AVE SE STE A140",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015092",
            "telephone_number": "503-588-2725",
            "fax_number": "503-588-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 NW HUGHWOOD AVE",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974705598",
            "telephone_number": "541-440-1914",
            "fax_number": "541-440-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEBURG DOUGLAS ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF RISK MANAGEMENT",
        "authorized_official_telephone_number": "503-588-2725"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "1273780464",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "520788",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bridgewood Rivers Assisted Living",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Assisted Living Facility in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; 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.