Kennewick Memory Care LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

Legal business name

KENNEWICK MEMORY CARE LLC

Doing business as

Windsong at Southridge

Practice address

4000 W 24TH Ave
Kennewick, WA 99338-2071

Phone

(509) 202-4327

NPI assigned

Oct 19, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Donald K Harris

Title

Member

Phone

(503) 991-6412

Specialties & licenses 1

Addresses

Other names 1

• Windsong at Southridge Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1144983883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1883 SW VISTA AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972012453",
            "telephone_number": "503-991-6412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 W 24TH AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993382071",
            "telephone_number": "509-202-4327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEWICK MEMORY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "503-991-6412",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Windsong at Southridge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kennewick General Hosital
• Kennewick General Hospital
• Kennewick General Hospital Pharmacy
• Kennewick Kidney Disease and Hypertension Clinic, PLLC
• Kennewick Medical Investors, LLC
• Kennewick Public Health District
• Kennewick Public Health District
• Kennewick Public Hospital District
• Kennewick Public Hospital District
• Kennewick Public Hospital District

• Alzheimer Center (Dementia Center) in Kennewick, WA
• Providers in Kennewick, WA by specialty
• Alzheimer Center (Dementia Center) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.