NPIMap

Organization Active NPI

Lagrande Assisted Living LLC

  • Assisted Living Facility
  • La Grande, OR
National Provider Identifier
1043337843
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
License
1621801256 Issued in OR
Legal business name
LAGRANDE ASSISTED LIVING LLC
Practice address
508 16TH St
La Grande, OR 97850-4400
Phone
(541) 663-1200
Fax
(503) 485-1279
NPI assigned
Mar 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 1621801256 OR Primary
Alzheimer Center (Dementia Center) 311500000X 1419410824 OR

Addresses

Primary practice location

508 16TH St
La Grande, OR 97850-4400

Mailing address

PO Box 3006
Salem, OR 97302-0006
Phone (503) 375-9016

Other names 1

  • Wildflower Lodge Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1043337843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3006",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973020006",
            "telephone_number": "503-375-9016",
            "fax_number": "503-485-1279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 16TH ST",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "978504400",
            "telephone_number": "541-663-1200",
            "fax_number": "503-485-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAGRANDE ASSISTED LIVING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "HARDER",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "503-485-4600"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "1621801256",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "OR",
            "license": "1419410824",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wildflower Lodge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Grande, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.