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Organization Active NPI

Cedar Ridge Retirement & Assisted Living Community LLC

Doing business as Cedar Ridge Retirement & Assisted Living Community

  • Point of Service
  • Salem, OR
National Provider Identifier
1083827745
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
1951 Issued in WA
Legal business name
CEDAR RIDGE RETIREMENT & ASSISTED LIVING COMMUNITY LLC
Doing business as
Cedar Ridge Retirement & Assisted Living Community
Practice address
3220 State St
Suite 200
Salem, OR 97301-6872
Phone
(503) 566-5715
Fax
(503) 588-3531
NPI assigned
May 8, 2007
Last updated
Oct 4, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 1951 WA Primary

Addresses

Primary practice location

3220 State St
Suite 200
Salem, OR 97301-6872

Mailing address

9515 198TH Avenue East
Bonney Lake, WA 98391
Phone (253) 299-6461

Other names 1

  • Cedar Ridge Retirement & Assisted Living Community Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Cedar Ridge Retirement Assisted Living Community2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1083827745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9515 198TH AVENUE EAST",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "98391",
            "telephone_number": "253-299-6461",
            "fax_number": "253-299-6475"
        },
        {
            "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",
            "fax_number": "503-588-3531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR RIDGE RETIREMENT & ASSISTED LIVING COMMUNITY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "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": "WA",
            "license": "1951",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cedar Ridge Retirement & Assisted Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salem, OR

Sources for this page

  • 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.