Red Cedar Canyon Assisted Living

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

12379 Issued in WI

Legal business name

RED CEDAR CANYON ASSISTED LIVING

Practice address

3001 Hanley Rd
Hudson, WI 54016-8273

Phone

(715) 381-7333

Fax

(715) 381-7313

NPI assigned

Oct 16, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Robert Donald Simonson

Title

Ceo

Phone

(608) 318-1180

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1144472572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 HANLEY RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168273",
            "telephone_number": "715-381-7333",
            "fax_number": "715-381-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HANLEY RD",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540168273",
            "telephone_number": "715-381-7333",
            "fax_number": "715-381-7313"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED CEDAR CANYON ASSISTED LIVING",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A",
        "authorized_official_last_name": "SIMONSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DONALD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "608-318-1180",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "WI",
            "license": "12379",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Hampton Randolph, CSAC, CSIT, LADC
• Ashley Rannells
• Rebecca K Rasmussen, PHARM D
• Sarah Lynn Rasmussen, OTR
• Morgan Taylor Rebeck, DDS
• Reformedicine, S.C.
• Refresh Midwest Operations, SC
• Katie Lea Reibel, DPT
• Jeffrey L Reichel, CRNA
• David Bradley Reker, NREMT, 68W

• Assisted Living Facility in Hudson, WI
• Providers in Hudson, WI by specialty
• Assisted Living Facility in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.