Mt. Pleasant Oakdale & Alz LLC

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

CRC-1428 Issued in SC

Legal business name

MT. PLEASANT OAKDALE & ALZ LLC

Practice address

1010 Anna Knapp Blvd
Mt Pleasant, SC 29464

Phone

(843) 971-7756

NPI assigned

Apr 24, 2007

Organization subpart

No

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) 375-9016

Specialties & licenses 1

Addresses

Other names 1

• Sweetgrass Court Senior Living Community Doing business as

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1184843989",
    "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": "1010 ANNA KNAPP BLVD",
            "city": "MT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-971-7756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT. PLEASANT OAKDALE & ALZ LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-24",
        "last_updated": "2008-07-25",
        "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": "503-375-9016"
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "SC",
            "license": "CRC-1428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sweetgrass Court Senior Living Community",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Mt Pleasant, SC
• Alzheimer Center (Dementia Center) in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.