Oak Lane, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

1237468898 Issued in OR

Legal business name

OAK LANE, LLC

Practice address

727 SW Rogue River Ave
Grants Pass, OR 97526-2777

Phone

(541) 476-7727

Fax

(541) 479-1362

NPI assigned

Jun 20, 2008

Organization subpart

No

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

Authorized official

Name

Elizabeth Marie Moss

Title

Director of Risk Management

Phone

(503) 588-2725

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Oak Lane Retirement Doing business as

Locations

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

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1205097342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HAWTHORNE AVE SE STE A140",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973015092",
            "telephone_number": "503-588-2725",
            "fax_number": "503-588-8653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 SW ROGUE RIVER AVE",
            "city": "GRANTS PASS",
            "state": "OR",
            "postal_code": "975262777",
            "telephone_number": "541-476-7727",
            "fax_number": "541-479-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK LANE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-20",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF RISK MANAGEMENT",
        "authorized_official_telephone_number": "503-588-2725"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "OR",
            "license": "1237468898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "513603",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Oak Lane Retirement",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jesse Michael Nussbaum, BA
• Regina K. O'Brien, LMT
• Renae Irene O'Gorman
• Leona O'Keefe, M.D.
• Megan O'Rourke-Allen
• Anne E. Obrien, P.T.
• Cynthia Louise Odell, LMT
• Teresa Oden
• David Oehling, M.D.
• Donald Ogan

• Assisted Living Facility in Grants Pass, OR
• Providers in Grants Pass, OR by specialty
• Assisted Living Facility in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 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.